Managed Care Healthcare And Risk Management Procedures

Managed care healthcare programs were started by the government to provide the people of the land with the necessary healthcare facilities that they need. These programs provide healthcare services to people at a much lesser cost as compared to normal besides helping improve the general quality of care itself too. This has been made possible through many different managed healthcare programs such as the Independent Practice Organization, the health Maintenance Organization, the Preferred Provider Organization and the Point of service to Managed Care organization in Indemnity insurance.

A person can get enrolled into any managed healthcare program for a small fee. Every managed care healthcare program has a number of eminent doctors and healthcare specialist in its panel. Every person enrolling in the program will be able to access the services of any of these doctors that he needs.

The different programs that are mentioned above – HMO, IPO, PPO, POS etc. are all offshoots of this basic principle with slight differences. For example in the IPO – the Independent Practice Association, the doctors that are associated with the managed care healthcare program also carry out their own healthcare practice besides the one that they provide to the people.

This model called as the managed care model has developed with different variants over a period of time. All these models have only slight differences as compared to the basic program of managed care. For example in IPO – Independent Practitioners Organization, the doctors who are on the panel are allowed to work on their own private practices too.

The managed care program is a very good program for everyone involved but it does has a few pitfalls. The program can work only when a large number of people agree to joining it.

But we must also remember that if everyone who joins also suffers from some or the other disease, then the whole program will turn unviable. The risk increases with every person that joins and not letting them join means hampering the growth of the program.

This is why for any managed care healthcare program, risk management is a very important thing that needs to be understood and taken care of. Risk management, especially financial risk management programs need to be implemented from the grass root level in such organization as that is the only way they can actually afford to and be able to provide low cost health services to people.

The impact of the managed care healthcare program on the patients’ lives is still a point of debate. Its proponents believe that it has increased the efficiency of treatment whereas those against argue that it has in fact increased the cost of care by nearly 25-30% for patients.

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