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Essay / Managed Care and Quality Improvement - 1296
Managed care is often viewed primarily as a cost reduction initiative that aims to manage costs and costs only in health care. For this and a few other reasons, managed care organizations face harsh judgments about the quality of care they provide. When analyzed correctly, the trends prove that managed care has actually played a very important role in determining and improving the quality of care. In this document, elements such as state and federal controls on MCOs, voluntary accreditations, standardized performance indicators, and examples of successful quality programs developed by MCOs will be used to prove this claim. Although in the eyes of many, managed care and quality do not go hand in hand, the research information provided in this article will show that MCOs place more emphasis on measuring and improving the quality of health care and should therefore be considered an important force in this area. Most of the managed care industry is governed and managed by for-profit organizations, leading many to believe that it is more focused on managing costs and making profits than on the quality of care provided to patients. individuals. Additionally, MCOs' legal policies place them in the difficult situation of having to put shareholders before consumers and/or payers. Furthermore, recent studies suggest that since financial risk has been transferred to providers through the capitation process, providers have become even more financially free to fail to provide all necessary care. However, the managed care industry has counterattacked these claims by demonstrating throughout the years that it is not just about managing costs, but also about managing and improving quality. Over time, it has been noted that MCOs... middle of document ...... the current state of the healthcare system indicates that managed care organizations actually play a very important role in the system health and the care it provides. delivers to beneficiaries and patients. Improvements in quality of care continue to grow across the board, but while there is much to celebrate, there is also much to work on and improve. Partnerships and compromises between MCOs, hospitals, insurance companies, health plans, practitioners, consumers and buyers need to be brought in to fill in the gaps and fill in the areas that are still far from perfect. It goes without saying that the healthcare system will never achieve complete perfection as it is an ever-changing industry that adapts and transforms over time, but if all components come together and work together, then the mission of providing each patient with the best possible care will be accomplished.