Managed care is an American health care plan that provides health insurance. Managed
care plans include a contractual agreement between health care providers and medical facilities
that provide the members of the care with a reduced cost of health services through simulative
competition and streamlined administration care (Smith & Goodwin, 2017). Managed care aims
at reducing the cost of health services to the members and attain an improved quality of care.
Managed care as a method of service delivery, has encouraged the transfer of healthcare services
to outpatient as well as other non-traditional settings of care.
“Analysis of managed care, and discuss how it, as a delivery method, has facilitated the
transfer of health services to outpatient and other nontraditional settings of care."
Outpatient health care services are all categories of services rendered to the patients
outside the traditional healthcare setting (hospital). These services are also referred to as
ambulatory care including the wellness and preventive care services, diagnostic care, treatment
as well as rehabilitation. With the approval of the Health Maintenance Organization Act in 1973,
there is controlled costs in both public and private healthcare markets for service delivery (Smith
& Goodwin, 2017). The managed costs by these organizations have influenced efficiency as well
as effectiveness in the healthcare service industry because of the creation of the service providers
across traditional and non-traditional health settings. Health providers operate with networks that
encourage a vast assortment of services in non-traditional health settings through an explicit set
of principles that would be used to select the most qualifying healthcare service, provider. Also,
managed care plan focuses on preventative care services that are not offered in the
MANAGED CARE ANALYSIS 3
hospitals/traditional health care settings only, but also non-traditional setting s like the
community (Schwartz et al., 2018).
Managed care plan providers establish the network plan for the plan. The amount of the
cash needed depends on the rules posted by the network selected. Managed care plans have
transferred healthcare services to outpatient and other non-traditional settings through the
distribution of programs in various types like HMO, PPO, and POS. Health Maintenance
Organization (HMO) is a type of managed care plan that only pays for care services within the
network after choosing a primary physician who will be coordinating most of the health care
services for you (Smith & Goodwin, 2017). Preferred Provider Organization (PPO) demands
more payment in case one receives care within the network. However, this type of plan pays a
portion of the healthcare service cost even if you go outside the system. Point of Service (POS) is
a managed care plan that gives room for the client to choose either HMO or a PPO plan anytime
they attend health facilities for medical care. These have encouraged channeling healthcare
services to outpatient and other non-traditional health settings (Hall, Orentlicher, Bobinski,
Bagley & Cohen, 2018).
“Discuss the impact managed care has on the access, financing, and delivery of health care in
the United States."
Managed care plan essentially aims at reducing the cost of healthcare service delivery while
enhancing the quality of care offered to the patients. Managed care have significantly influenced
the affordability and accessibility of the healthcare services throughout the United States
population. Managed care plans have provided fee-for-service as well as traditional indemnity
insurance plans thus giving the physicians an opportunity to have incentives of delivering
MANAGED CARE ANALYSIS 4
healthcare services of negligible worth to their patients (Hall, Orentlicher, Bobinski, Bagley &
The managed care plan is the most common type of healthcare plan in the United States
has primarily provided healthcare solution for people from low socio-economic backgrounds.
The services are easily accessible and affordable. This is because managed care plans have
encouraged immediate primary care services. People have been given the opportunity to care for
their health at a considerable certainty level. Prescription management of the care services is
improved because the health care network providers collaborate with the pharmaceutical
agencies to make sure that the prescriptions are accessible at an affordable price (Schwartz et al.,
Managed care has significantly influenced the cost of healthcare services. It has lowered
the prices of the services for those who have the insurance coverage. This is the major goal of the
managed care system. However, the reduced costs don't sacrifice the quality of the services
rendered. The reduced costs and enhanced quality of services have been achieved through the
establishment of the network of service providers who offers care services as well as referrals
(Schwartz et al., 2018). If people are loyal to their network care provider, procedures and
services, are discounted.
"Discuss managed care's role in promoting health."
Managed care programs and systems are essential in promoting health. Especially,
managed care programs have enhanced preventative care in the population as well as healthcare
facilities. The managed health care plans are effective in controlling chronic diseases via
preventative care (Smith & Goodwin, 2017). According to Frank, Glazer & McGuire (2017),
managed care provides chances for public health improvement through a structured format.
MANAGED CARE ANALYSIS 5
Because the primary aim of the managed care plan is to reduce the cost without sacrificing the
quality of health care services, managed care organizations focus on population-based research
that attempts to attain the most suitable public health outcomes. The managed care organization
also provide civic education to its subscribers that offer insights about health incentives.
Managed care along with the public health departments work collaboratively to provide health
care services to the public. Therefore, it makes the duo get concerned with the population health,
and its intervention systems that improve the health of the community (Frank, Glazer &
Managed care aims at reducing the cost of health services to the members and attain an
improved quality of care. Managed care as a method of service delivery, has encouraged the
transfer of healthcare services to outpatient as well as other non-traditional settings of care.
Outpatient health care services are all categories of services rendered to the patients outside the
traditional healthcare setting (hospital). The managed costs by these organizations have
influenced efficiency as well as effectiveness in the healthcare service industry because of the
creation of the service providers across traditional and non-traditional health settings. Managed
care have significantly influenced the affordability and accessibility of the healthcare services
throughout the United States population. Managed care programs and systems are essential in
promoting health. Specially, managed care programs have enhanced preventative care in the
community as well as healthcare facilities.
MANAGED CARE ANALYSIS 6
Frank, R. G., Glazer, J., & McGuire, T. G. (2017). Measuring adverse selection in managed
health care. In Models of Health Plan Payment and Quality Reporting (pp. 29-57).
Retrieved from https://www.worldscientific.com/doi/abs/10.1142/9789813202887_0002
Hall, M. A., Orentlicher, D., Bobinski, M. A., Bagley, N., & Cohen, I. G. (2018). Health care
law and ethics. Wolters Kluwer Law & Business.
Schwartz, P., Gao, W., Kreitman, J., Hamilton, G., Keleti, D., Michael, K. E., & Gelzer, A. D.
(2018). Inverse Correlation of Decreased Opioid Utilization and Increased Medical
Assisted Therapy in US Medicaid Managed Care. The value in Health, 21, S189.
Retrieved from https://www.valueinhealthjournal.com/article/S1098-3015(18)31578-
Smith, J., & Goodwin, N. (2017). Towards managed primary care: the role and experience of
primary care organizations. Routledge. Retrieved from