NOTE: Free essay sample provided on this page should be used for references or sample purposes only. The sample essay is available to anyone, so any direct quoting without mentioning the source will be considered plagiarism by schools, colleges and universities that use plagiarism detection software. To get a completely brand-new, plagiarism-free essay, please use our essay writing service.
One click instant price quote
Of the approximately 260 million people currently living in the United States of America, every one of them has a need for effective, affordable and accessible health care coverage and services. Within the past thirty to forty years, the scope and cost of health care coverage and services has drastically changed, Altering the manner in which health care was previously managed. There are several factors that have affected the cost of healthcare coverage over the past two to three decades. One of these factors is the introduction and rapidly increasing enrollment by people in managed health care insurance plans. Managed health care insurance plans cans help to alleviate the rising costs of effective medical coverage.
Another important factor that has affected health care costs is the invention and use of new medical technologies. As leading researchers and economic analysts have discovered there is a distinct and direct correlation between advancing medical technologies and rising health care costs. Medical innovation has been proven time and again to be an important determination of health care cost. It would appear that managed care health insurance plans which attempt to lower health care costs, and highly expensive new medical innovations and procedures are at cross road pulling against one another in very different directions. Market-level studies have had found the cost growth of health care in markets with greater managed care access to be generally slower than that of non-managed care health insurance markets. However, managed care is unlikely to prevent the share of gross domestic product spent on healthcare from rising unless the cost-increasing nature of new medical technologies changes.
Managed care health insurance plans differ greatly from indemnity fee-for-service, or FFS insurance plans. Since the early 1970 's, rapidly growing enrollment in managed care health insurance plans has transformed the health insurance market in the United States. Virtually nonexistent in most markets three decades ago managed care health plans covered 63 percent of t he nation's employees by 1994. Managed care incorporates a range of features that allow the insurer greater influence in the process of medical care. Managed care plans aggressively bid for lower prices from physicians and hospitals in an attempt to minimize the use of health care services by monitoring providers and changing provider incentives. Health insurance providers that operate under the fee-for-service concept grant the consumer alot more freedom of choice concerning doctors and treatment programs this would free the consumer of any feelings of discontent with "interfering" insurance companies. !
Consumers of indemnity plans, however pay a price for that freedom like having to pay drastically higher rates and little knowledge input on doctors, specialists and nearby hospitals that will fit their particular needs. Many of today's health insurance consumers choose to place their trust in a managed care insurance company relying on the expertise of the provider to support and provide their various medical treatments and needs. Health maintenance organizations commonly known as HMOs, have emerged as the leader of managed care providers. Other types of managed care plans include preferred provider organizations, point of service plans and managed indemnity plans. Most studies focus on HMOs and do not describe differences in the type of HMO or the level of management in non-HMO plans. HMOs have effectively reduced health care expenditures.
A natural assumption would be that the quality of care would be lowered as insurance rates go down and remain affordable. However, these cost savings have been achieved according to most evidence without significant reductions in the quality of care. This suggests that managed care health insurance plans like-HMOs in particular tend to reduce inefficiencies in the health care system in fact, a study that examined changes in hospital expenses in California found as much as a 44 percent slower rate of hospital care cost growth in markets with high HMO penetration relative markets with low HMO access Their are two main types of services that managed care health insurance companies use to categorize and label their treatments and procedures these categories are known as complementary services and substitutive services. These two terms apply to new innovations in medical technology and the amount of money spent to provide the technology to the consumer. Complementary services are those whose use increases with the use of the new technology. Complementary services are for the consumer, who understandably desires the latest most effective medical technology to treat themselves -and their loved ones.
For example, suppose an improvement were to made in the field of x-rays. This improvement could provide clearer, higher quality images, thus leading to better surgery outcomes. The likelihood of a better surgical outcome may result in more individuals opting to receive surgical treatment. The development of this new technology in diagnostic imaging would no doubt have been highly expensive.
Also, the costs associated with an illness in which there is an increased need for surgery are usually quite high. If an innovation leads to greater use of complementary services, expenditures rise more than would be predicted by simply looking at the direct expenditures on the innovation. In this case x-rays and surgery are complementary technologies. This example suggests that the use of complementary services may increase the costs associated with use of new innovations by as much as 50 percent. Substitutive services on the other hand are different in that they are not provided because of the of new technologies. The savings associated with the avoiding these services offset the costs of the technological innovations and complementary services.
If the innovation results in improved health outcomes, substitution away from services that would have been consumed later may also happen. It is also hoped that this type of substitution would accompany most preventive services and many other innovations that provide a reduction in morbidity in the long-run. Evidence suggests that medical innovations has led to higher expenditures on health care services. It appears that if the rising cost of health care that results from technological advances remain unchecked by managed care, the effect of technological progress will tend to offset any cost savings achieved by managed care through lower prices or lower use of traditional services.
Factors such as population increases, extended life expectancy and the inflation rate have made health care costs rise up. However, studies have proved that important advances in specific areas of medical technology have had the most intense effect on health care costs. This finding still applies when it is considered in managed care health insurance plans to a certain undeniable extent. Studies have been conducted during many times over the course of the past several decades, focusing on substantial increases in health care costs in direct correlation to particular medical procedures and fields. Among these procedures and fields are child birth, radiation therapy, coronary bypass surgery, nuclear medicine and cancer treatments. For example the use of cesarean sections used during problematic child deliveries has increased health care costs.
The various medical personnel must all be compensated for their time and labor, the! anesthesiologists, the surgeon, the nurses, etc. Also raising health care costs are fetal monitoring and ultrasound techniques. In the case of breast and other cancers, radiation therapy as well as combination therap...
Free research essays on topics related to: health care insurance, health care services, health care costs, managed care plans, health care coverage
Research essay sample on Management Seminar On Managed Health Care And Technology
