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Managed Care Report Card - Essay Example

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Managed Care Report Card Name: Institution Managed care was previously dominated by non-profiting making organizations since their main mission was to provide quality care to the society, especially the needy. Over the recent past, most health care companies including both public and private health care providers practice managed care…
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Managed Care Report Card
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Download file to see previous pages A health care report card can be compared to a student’s report care, just as a student report card shows the child’s performance on various subjects, a health care report card shows how a health care plan faired on various subjects in terms of quality service provision. In addition to this, it can also show the comparison of health plans to the national average for a service. Some health report cards grade home health agencies, doctors, hospitals and other health care providers. The main purpose of this managed health care report card is to help a person be able to make an informed decision on which health plan best suits the needs and expectations of his / her family (Health plan report card, n.d). In this research, a managed health care company that has an online listed report will be analyzed based on its scores and make recommendations on areas that need improvement. The managed care company under study was CIGNA Health Care. Cigna health care is one of the largest global health service companies in the United States, whose main goal is to aid the people they serve recover their state of health, security and the overall well being (Kerber et al, 2002). A look at their report card shows performance information about appropriate care, diabetes ongoing care, medical care, staying healthy, youth care, youth wellness, provider network customer satisfaction, experience of care and mental health. A general overview of the managed health care report shows that the company is above average in terms of overall performance. The only categories with percentages below 50% are youth wellness; that is testing for Chlamydia which was rated at 48%, appropriate treatment for adults with acute bronchitis rated at 29% and appropriate testing for chronic obstructive pulmonary disease (COPD), rated at 39%. All the other categories, were above average with those rated highest being; appropriate medications for adults with asthma rated at 90%, early prenatal care rated at 99%, claims processing rated 99%, provider communication rated 95%, getting care quickly rated 89% and follow up for mental illness within 30 days rated at 89% (About health quality, n.d). All the above scores both high and low were as a result of various factors affecting the health care company. One of the factors leading to the good performance was the clearly stated mission and goals of the company. Well defined mission and goals is one for the most fundamental characteristics of a successful quality program. The company’s’ goals to provide quality health care and security among others has contributed to its exemplary performance especially in satisfying their customers. Effective planning is also a factor that may have contributed to their high scores. This includes proper documentation of what they intend to do over a given period of time and how they are going to achieve the set objectives. Poor planning usually results to poor results Cigna health care has implemented the principle of proper planning, and as a result, it has helped them provide quality health care which has reflected on their report card. Factual approach to decision making is also a factor that has contributed to their high scores. Based on the various surveys the company has conducted on their customers/patients, they have been able to use the information acquired from the field assessment to ...Download file to see next pages Read More
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