Choose a common myth associated with managed care. You may use one of the myths discussed in this week’s reading assignment, or come up with one on your own. Write a 1-2 page analysis on why you think this myth came about and why it still may be prevalent today. Explain to what degree the myth is based on facts, truths, and misunderstandings.
Summarize the evidence from research that counters or supports the premise of your myth. Conduct research in at least two sources, not including your textbook. Cite your sources using APA style guidelines.
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Introduction:
Managed care is a type of healthcare delivery system that seeks to control the cost and quality of medical services. However, there are many myths associated with managed care that have led to misunderstandings among patients and healthcare providers. In this analysis, I will discuss a common myth associated with managed care, why it came about and why it still may be prevalent today. Additionally, I will provide evidence from research that either supports or counters the premise of the myth.
Myth:
One common myth associated with managed care is that it limits patients’ access to medical care. This myth has been perpetuated by the belief that managed care organizations (MCOs) prioritize cost-cutting over quality of care and patient needs. Managed care has been portrayed as a system that is more concerned with cost savings and its profits than providing high-quality care to patients. This misconception has led many patients to have negative attitudes towards managed care.
Analysis:
The myth that managed care limits patients’ access to medical care came about due to several factors. Managed care was introduced in the United States in the 1970s as a means of controlling healthcare costs. At this time, the US healthcare system was characterized by a fee-for-service model, where providers were paid for each service rendered. This led to an increase in healthcare costs, and policymakers sought alternative ways of controlling costs. This led to the creation of managed care, which was geared towards providing cost-effective healthcare services.
The perception that managed care limits access to care is not entirely based on facts or truth, but rather misunderstanding. Managed care provides comprehensive healthcare services to its members. The services include preventive services, outpatient services, and inpatient hospital care. MCOs also contract with a network of providers, including hospitals, physicians, and medical specialists, to provide services to their members. Therefore, members have access to a wide range of healthcare services, and the MCOs ensure that members receive timely and appropriate care. Also, managed care organizations emphasize preventive care, which reduces the need for more extensive treatment in the future.
Research has shown that managed care does not limit patients’ access to medical care. A study by Kane et al. (1998) compared patients’ access to care under a fee-for-service model and a managed care model. The study found that patients under the managed care model had better access to preventive services, specialist care, and hospital care than those under the fee-for-service model. Another study by Dafny et al. (2012) found that managed care organizations achieve cost savings through efficiencies in healthcare delivery rather than limiting patients’ access to care.
Conclusion:
The myth that managed care limits patients’ access to medical care is a misconception perpetuated by misunderstanding of the concept of managed care. The reality is that managed care provides comprehensive healthcare services to its members and emphasizes preventive care. Research has shown that managed care organizations achieve cost savings through efficiencies in healthcare delivery rather than limiting access to care. Therefore, it is essential to debunk this myth and educate patients on the benefits of managed care.
