1. Discussion Question #1 Managed health care
Discussion Question #1 Managed health careDiscussion Question #1 Managed health
careReply prompt: Respond to the two discussion questions from classmates who reached a
different conclusion than you did. Identify the points of difference in your analyses and
explain how your sources and analysis led you to your conclusion. Replies must be at least
450 words each discussion reply. Each reply must reference at least 3 scholarly sources and
follow current APA format (including both in-text citations and a reference list). You must
also support each reply with thoughtful analysis (considering assumptions, analyzing
implications, and comparing/contrasting concepts and include thorough biblical worldview
integration.Discussion Question #1IntroductionManaged health care is defined as “a
mechanism of providing health care services in which a single organization takes on the
management of financing, insurance, delivery and payment “(Shi &Singh, 2017). The first
health maintenance organization (HMO) is said to have been the Western Clinic in Tacoma
Washington in 1910. It offered a range of medical services to lumber mill owners and their
employees for a cost of fifty cents per month (Fox & Kongstvedt, 2007). The HMO act of
1973 introduced the capitation system as opposed to the fee- for service system to help
reduce the increasing cost to Medicare. The full effects of the act were not enacted until
1977 at which time the number of HMO’ s bean to rise. The preferred provider organization
(PPO) entered the game in the late 70’s and early 80’s (Fox & Kongstvedt, 2007).Discussion
Question #1 Managed health careExplain the growth of managed care that began in the
1980’sThe growth of managed health care in the 1980’s was due to the out of control
increases in health care. The consumer price index rose by 59% but medical care was up
117% (Shi &Singh, 2017). Most companies began to use the MCO’s to help decrease the
health care costs because they were affecting the profitability of the company. Medicare and
Medicaid began to use MCO’s to control costs but also to ensure quality of care based on
patient need not the current fee for service where physicians would order unnecessary tests
or procedures (Shi &Singh, 2017). During the last of the 1990’s MCO’s began to decline due
to public opinion concerning the quality of care and the amount of control the MCO’s had
over the reimbursement and utilization aspects pertaining to hospitals and physicians.How
has health care delivery evolved?The future of health care delivery will see an increase in
various types of managed care options ranging from the long time HMO and PPO to the
newer Accountable Care Organization (ACO) and the Patient-Centered Medical Home
(PCMH). The ACO is an integrated delivery system (IDS) that includes hospitals, physicians
and post discharge care. The ACO must be a legal entity and have a governing body to
2. provide oversight (Shi &Singh, 2017). PCMH’s focus on the patient beyond their medical
needs. “Each patient is unique and will have specific needs” (Rusnuck,2017). The practice
must be: physician-led, comprehensive, coordinated, accessible, and committed to quality
and safety(Rusnuck,2017).Based on the literature, what does the future hold?As our
population grows and ages we will need a solid health care system to provide the best
quality care while controlling costs. As Aristotle said, “The whole is greater than the sum of
its parts.” It will take a community effort on the part of the financing, insurance, delivery
and payment groups to achieve the ultimate health care product. We can expect for MCO’s
to continue to shape our health care system. There will be a continuing push for quality of
life for patients and incentives and accountability for health care providers. Discussion
Question #1 Managed health careConclusionPhilippians 2:4-7 states “Don’t look out only for
your own interests, but take an interest in others, too. You must have the same attitude that
Christ Jesus had. Though he was God, he did not think of equality with God as something to
cling to. Instead, he gave up his divine privileges; he took the humble position of a slave and
was born as a human being. When he appeared in human form.” If we can develop a strong
managed heath care plan with this verse in mind we may be able to have a plan that will
benefit the investors as well as the patient. (word count 609)ReferencesA quote by
Aristotle. (n.d.). Retrieved August 10, 2017,
fromhttps://www.goodreads.com/quotes/20103-the-whole-is-greater-than-the-sum-of-
its-parts.Fox, P., & Kongstvedt, P. (2007). The Essentials of Managed Health Care (Fifth ed.).
Sudbury,MA: Jones and Bartlett.Rusnak, W., M.D. (2017, March 22). How Patient-Centered
Medical Homes Are Transforming Primary Care. Retrieved August 10, 2017, from
https://www.nuemd.com/blog/patient-centered-medical-homes-transforming-primary-
care.Shi, L., & Singh, D. (2017). Essentials of the U.S. Health Care System (Fourth ed.).
Burlington, MA: Jones & Bartlett Learning.ORDER NOW FOR CUSTOMIZED, PLAGIARISM-
FREE PAPERS
