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Managed care and children with chronic illness - Case Study Example

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Running head: MANAGED CARE AND CHILDREN WITH CHRONIC ILLNESS Managed care and children with chronic illness Insert name Insert Insert May 4th, 2011. Managed Care and Children with Chronic Illness Managed care has been deemed crucial for utilization by various organizations in counter to chronic diseases that have rampantly affected children in the recent years…
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Managed care and children with chronic illness
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Download file to see previous pages However, distinct criteria are utilized by managed care providers to distinct degrees of medical care requirements. The recent decades are marked by the attachment of great value to such groups by the states that are faced with high levels of medical needs with an intention of including the poor and the needy in the healthcare programs. Nevertheless, the provision of these services has been limited by certain factors, thus leading to the denial of these services to some children with chronic ailments despite their being needy. Nevertheless, managed care ahs a rationale of providing care services at reduced costs to the patients as well as treatment efficiency measures are of high levels (Perkin, Swift, and Newton 2007). The discussion in this paper is a case study to investigate and establish Managed care and children with chronic illness. The comprehension of this will be enhanced by the study of the scope of the managed care as well as the chronic illnesses that need the managed care. In addition, it is deemed crucial to establish the managed care providers as well as the rationale for such services when provided to patients. More crucial, an explanation will be provided for the criteria which children with chronic disease are covered or denied by managed care (HMO, MEDICAID). Managed care and the ideal providers; Managed care is a term utilized in the US in the description of a diversity of techniques that are put in use with the intention of decreasing the healthcare costs. They are also deemed as a rationale for the provision of benefits of health as well as the improvements of care quality provided by the practitioners. The systems in use are those that imply financing and delivering healthcare benefits and service to those that e enroll. Hence, they are often referred to as healthcare concepts and techniques that are managed by a responsible body. The intentions for the steer towards the utilization of such programs are inclusive of the reduction of the healthcare care costs, some of which are deemed unnecessary via the use of particular viable mechanisms. The provision of economic incentives for care providers as well as their patients, in order to provide room for their selection of programs that are less costly is a long term rationale for the managed care. Specific services review performance and increased cost sharing services for beneficiaries are also the major functions of the managed care. They are also deemed crucial in the control of admissions for patients as well as reducing the lengths f time that patients have to wait for treatments. A variety of settings is deemed vital in the provision of such services, which are inclusive of Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO) etc (Birenbaum, 1997). HMO is a managed care entity that provides managed care health coverage to its clients, and based in the United States. The fulfillment of such services offer is done via hospitals, doctors or any other form of medical practitioners, all of those that have gained contract with the organization. Its running is based on the 1973 Health Maintenance Organization Act, which requires that public or private organizations with 25 and ...Download file to see next pagesRead More
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