Author Question: Managed care was a methodology adopted in the 1980s and 1990s. It is a system designed to deliver ... (Read 54 times)

Kikoku · **on:** Jul 8, 2018

Managed care was a methodology adopted in the 1980s and 1990s. It is a system designed to deliver through a specific network of providers and to reduce costs. However, the cost saving was short-lived because:

1. Consumer groups did not endorse the plans.
2. Clients had been used to access to providers of their choice and unlimited service.
3. Medicare and Medicaid took over these plans, making them unnecessary.
4. The system lacked proper payment to physicians and many practitioners went out of business.

Question 2

The role of the case manager as coordinator is to:

1. Provide information to all parties on the state of the member and situations af-fecting client
2. Educate client and providers about the case management process so that informed decisions can be make
3. Support all parties to work toward mutual goals
4. Arrange, regulate, and balance needed health services for clients

honnalora · **Reply #1 on:** Jul 8, 2018

Answer to Question 1

2
Consumer groups were not only used to freedom of choice and unlimited service, but they did not like the ideas of short-stay maternity care and denial of bone marrow transplantation for breast cancer patients.

Answer to Question 2

4
No. 1 is monitor/reporter, No. 2 is educator, and No. 3 is facilitator.