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MYTH OF MANAGED CARE 2
The myth of Managed Care
Marion Allen
Rasmussen College
Foundations of Managed Care
May 31, 2020
Part 1: Outline
The main myth that drew my attention is that managed care is
that HMOs threaten the quality of care. HMOs equal (bad) for-
profit medicine. This research shall report on the validity or
invalidity of this myth. From my point of view, the myth is
invalid as it will be supported by the points highlighted below:
1) The goal of HMOs is to ensure that there is enough health
care is available to society at the most affordable means.
2) HMOs exist as insurance set up for the cultural aspects of the
people. This is due to the presence of the domineering
medicinal culture in this land.
The topics in this writing shall include:
1) Fact elaboration-this will describe the fact about the myth
presented here. It is factual to say that 0.89 of members of
HMOs in Massachusetts are non-profit mind oriented. Most of
the members here are among the excellent members of the
country (Luft, 1980).
2) The impact of the myth to the public. It takes the bold
citizens to refute this myth, and probably, the teenagers are in
the light of successfully rebutting it. Under this topic, I shall
include two subtopics which include:
2a) The impact of the myth on the teenagers
2b) The effect of the myth on the seniors. Society is made to
believe in the worse managed health care.
3) The impact of the myth on the objective of HMOs (Relman &
Reinhardt,1986). The main aim of HMOs is to enhance excellent
health care that many citizens can afford.
4) Impact of the myth on the economy.
The following are the sub-topics under this topic:
4a) Impact on the local economy.
4b) Impact on the global economy.
Part 2: Annotated Bibliography
Christianson, J. B., Sanchez, S. M., Wholey, D. R., & Shadle,
M. (1991). The HMO industry:
Evolution in population demographics and market structures.
Medical Care Review, 48(1), 3-46.
The authors, Christianson et al., reviewed the topic under the
HMO industry and came up with a conclusion that HMOs were
in existence in the 1980s and helped in improving the lives of
the citizens in the United States. They wrote that the prolonged
stay of the patients in the hospitals made people include
political oppositions. The contribution of these authors is useful
in this research as it helps in analyzing the impact of the myth
on the various individuals in society, specifically the seniors
who spread political stories. It helps in determining the validity
of the myth.
Luft, H. S. (1980). Assessing the evidence on HMO
performance. The Milbank Memorial Fund
Quarterly. Health and Society, 501-536.
Luft is an author who contributed to the literature concerning
the profit issue related to the HMOs. It is evidenced that
prepaid services have been in place for a long time in the USA,
and thus this constitutes the culture of health providers. In
writing, this author explains how traditional medicine men view
managed care. It is done in a way to reduce the cost of
operations to ensure that the physicians receive huge profits.
This author's contribution is vital as it sheds light on what to
talk about in my research concerning the impact of the myth
concerning profitability issues.
Relman, A. S., & Reinhardt, U. E. (1986). Debating for-profit
health care and the ethics of
physicians. Health Affairs, 5(2), 5-31.
Relman and Reinhardt Wrote about the for-profit and the ethics
of the physicians. The physicians in this context form the part
of the community in which my study intends to study how the
myth at hand impacts it. Thus, using this knowledge, this
research shall be sufficient.
References
Christianson, J. B., Sanchez, S. M., Wholey, D. R., & Shadle,
M. (1991). The HMO industry:
Evolution in population demographics and market structures.
Medical Care Review, 48(1), 3-46.
Luft, H. S. (1980). Assessing the evidence on HMO
performance. The Milbank Memorial Fund
Quarterly. Health and Society, 501-536.
Relman, A. S., & Reinhardt, U. E. (1986). Debating for-profit
health care and the ethics of
physicians. Health Affairs, 5(2), 5-31.
Running head: MYTH OF MANAGE CARE 1
Myth of Managed Care
Marion Allen
Rasmussen College
Foundations of Managed Care
May 24th, 2020
1
Sandi Moore-Foggey @ 2020-05-29T15:26:48-07:00
Omit the words, "running head".
TITLE OF PAPER 2
Myth of Managed Care
One common myth I found associated with managed care is that
HMOs threaten the
quality of care. Managed health care as it was developed in the
USA, and the current backlash
towards it, must be viewed in the traditional context of the U.S.
health care system and
conditioned both providers' and patients' expectations of
unlimited resources and free choice(5).
In this essay, I will be going over why these myths are not valid
and provide supporting facts.
The most comprehensive analysis of comparisons on
quality found that HMOs provide care
that is generally better than or equal to fee-for-service care.
However, HMOs should not be
satisfied with "equal to," since geographic variations in medical
practice patterns under fee-for-
service, documented by John Wennberg, M.D., and his fellow
researchers, point to significant
quality of care concerns throughout American medicine. HMOs
are leading long-overdue efforts
to measure the quality of care so that they can stay up to
standard. (6)
The managed care industry should be able to withstand these
criticisms if it were making
huge profits, a charge leveled by providers and the public.
Although controlled care use has
continued to grow steadily, the net income of most managed
care organizations has plummeted.
In 1997, for a reported collective loss of almost 1 billion. As a
result, health plans have
significantly raised employer premiums for the third year. They
now find their previous allies,
the funders of care, frustrated and antagonistic.
Review of the statics on managed care performance since
around 1980 had six studies cite
that HMO plan enrollee can receive more preventive tests,
examinations, and health promotion
2
3
Sandi Moore-Foggey @ 2020-05-29T15:27:57-07:00
You are missing the "title" of your paper.
Sandi Moore-Foggey @ 2020-05-29T15:37:18-07:00
Make sure to indent five spaces.
TITLE OF PAPER 3
services than plan enrollees (3). Managed care extends coverage
to preventive visits and
screening, which is beneficial to vulnerable areas of
populations. Part of the RAND Health
Insurance experiment found that youth assigned to an HMO had
a 40% greater number of routine
preventive visits and 50% more office visits than a control
group attached to a fee-for-service
plan (4).
So, conclusion factual data has shown there is no proven fact
that if you use a HMO plan you
are risking not receiving quality care. Personally, I use an HMO
plan as it is very affordable and
allows me to choose my Doctors without waiting on a referral.
This type of freedom allows me
easy access to transition my care from the provider to the next,
which is vital in receiving a high
quality of care. Choosing your healthcare plan should be
tailored around what benefits you or
your family.
4
Sandi Moore-Foggey @ 2020-05-29T15:39:42-07:00
Make sure your are double-spacing only.
TITLE OF PAPER 4
References
(1) Platt BD, Stream LD. Dispelling the negative myths of
managed care: an analysis of anti-managed
care legislation and the quality of care provided by Health
Maintenance Organizations. Florida
State University Law Review, 1996: 23: 489–510.
(2) Miller RH, Luft HS. Does managed care lead to better or
worse quality of care? Health Affairs, 1997,
16 (5): 7–25.
(3) Miller RH, Luft HS. Managed care plan performance since
1980. Journal of the American Medical
Association, 1994, 271: 1512–1516
(4) Managed Care - DocShare.tips.
http://docshare.tips/managed-
care_574b1fccb6d87f5f2d8b4ee8.html
(5) Special Theme – Health Systems Managed care: the US
experience.
https://www.who.int/bulletin/archives/78(6)830.pdf
(6) Six major myths of managed health care By John Kingsdale
July 27, 1998
Retrieved on May 24, 2020 from
https://www.bizjournals.com/boston/stories/1998/07/27/editoria
l2.html?page=all
5
http://docshare.tips/managed-
care_574b1fccb6d87f5f2d8b4ee8.html
http://docshare.tips/managed-
care_574b1fccb6d87f5f2d8b4ee8.html
https://www.who.int/bulletin/archives/78(6)830.pdf
https://www.bizjournals.com/boston/stories/1998/07/27/editoria
l2.html?page=all
Sandi Moore-Foggey @ 2020-05-29T15:31:48-07:00
Please refer to the APA link on the course home page. Your
references should be in alphabetical order and not numbered.
Comment Summary
Page 1
1. Omit the words, "running head".
Page 2
2. You are missing the "title" of your paper.
3. Make sure to indent five spaces.
Page 3
4. Make sure your are double-spacing only.
Page 4
5. Please refer to the APA link on the course home page. Your
references should be in alphabetical order and not
numbered.

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MYTH OF MANAGED CARE2The myth of Managed CareMario.docx

  • 1. MYTH OF MANAGED CARE 2 The myth of Managed Care Marion Allen Rasmussen College Foundations of Managed Care May 31, 2020 Part 1: Outline The main myth that drew my attention is that managed care is that HMOs threaten the quality of care. HMOs equal (bad) for- profit medicine. This research shall report on the validity or invalidity of this myth. From my point of view, the myth is invalid as it will be supported by the points highlighted below: 1) The goal of HMOs is to ensure that there is enough health care is available to society at the most affordable means. 2) HMOs exist as insurance set up for the cultural aspects of the
  • 2. people. This is due to the presence of the domineering medicinal culture in this land. The topics in this writing shall include: 1) Fact elaboration-this will describe the fact about the myth presented here. It is factual to say that 0.89 of members of HMOs in Massachusetts are non-profit mind oriented. Most of the members here are among the excellent members of the country (Luft, 1980). 2) The impact of the myth to the public. It takes the bold citizens to refute this myth, and probably, the teenagers are in the light of successfully rebutting it. Under this topic, I shall include two subtopics which include: 2a) The impact of the myth on the teenagers 2b) The effect of the myth on the seniors. Society is made to believe in the worse managed health care. 3) The impact of the myth on the objective of HMOs (Relman & Reinhardt,1986). The main aim of HMOs is to enhance excellent health care that many citizens can afford. 4) Impact of the myth on the economy. The following are the sub-topics under this topic: 4a) Impact on the local economy. 4b) Impact on the global economy.
  • 3. Part 2: Annotated Bibliography Christianson, J. B., Sanchez, S. M., Wholey, D. R., & Shadle, M. (1991). The HMO industry: Evolution in population demographics and market structures. Medical Care Review, 48(1), 3-46. The authors, Christianson et al., reviewed the topic under the HMO industry and came up with a conclusion that HMOs were in existence in the 1980s and helped in improving the lives of the citizens in the United States. They wrote that the prolonged stay of the patients in the hospitals made people include political oppositions. The contribution of these authors is useful in this research as it helps in analyzing the impact of the myth on the various individuals in society, specifically the seniors who spread political stories. It helps in determining the validity of the myth. Luft, H. S. (1980). Assessing the evidence on HMO performance. The Milbank Memorial Fund Quarterly. Health and Society, 501-536. Luft is an author who contributed to the literature concerning the profit issue related to the HMOs. It is evidenced that prepaid services have been in place for a long time in the USA, and thus this constitutes the culture of health providers. In writing, this author explains how traditional medicine men view managed care. It is done in a way to reduce the cost of operations to ensure that the physicians receive huge profits. This author's contribution is vital as it sheds light on what to talk about in my research concerning the impact of the myth concerning profitability issues. Relman, A. S., & Reinhardt, U. E. (1986). Debating for-profit
  • 4. health care and the ethics of physicians. Health Affairs, 5(2), 5-31. Relman and Reinhardt Wrote about the for-profit and the ethics of the physicians. The physicians in this context form the part of the community in which my study intends to study how the myth at hand impacts it. Thus, using this knowledge, this research shall be sufficient. References Christianson, J. B., Sanchez, S. M., Wholey, D. R., & Shadle, M. (1991). The HMO industry: Evolution in population demographics and market structures. Medical Care Review, 48(1), 3-46. Luft, H. S. (1980). Assessing the evidence on HMO performance. The Milbank Memorial Fund Quarterly. Health and Society, 501-536. Relman, A. S., & Reinhardt, U. E. (1986). Debating for-profit
  • 5. health care and the ethics of physicians. Health Affairs, 5(2), 5-31. Running head: MYTH OF MANAGE CARE 1 Myth of Managed Care Marion Allen Rasmussen College Foundations of Managed Care May 24th, 2020 1 Sandi Moore-Foggey @ 2020-05-29T15:26:48-07:00 Omit the words, "running head". TITLE OF PAPER 2 Myth of Managed Care One common myth I found associated with managed care is that HMOs threaten the
  • 6. quality of care. Managed health care as it was developed in the USA, and the current backlash towards it, must be viewed in the traditional context of the U.S. health care system and conditioned both providers' and patients' expectations of unlimited resources and free choice(5). In this essay, I will be going over why these myths are not valid and provide supporting facts. The most comprehensive analysis of comparisons on quality found that HMOs provide care that is generally better than or equal to fee-for-service care. However, HMOs should not be satisfied with "equal to," since geographic variations in medical practice patterns under fee-for- service, documented by John Wennberg, M.D., and his fellow researchers, point to significant quality of care concerns throughout American medicine. HMOs are leading long-overdue efforts to measure the quality of care so that they can stay up to standard. (6) The managed care industry should be able to withstand these criticisms if it were making
  • 7. huge profits, a charge leveled by providers and the public. Although controlled care use has continued to grow steadily, the net income of most managed care organizations has plummeted. In 1997, for a reported collective loss of almost 1 billion. As a result, health plans have significantly raised employer premiums for the third year. They now find their previous allies, the funders of care, frustrated and antagonistic. Review of the statics on managed care performance since around 1980 had six studies cite that HMO plan enrollee can receive more preventive tests, examinations, and health promotion 2 3 Sandi Moore-Foggey @ 2020-05-29T15:27:57-07:00 You are missing the "title" of your paper. Sandi Moore-Foggey @ 2020-05-29T15:37:18-07:00 Make sure to indent five spaces. TITLE OF PAPER 3
  • 8. services than plan enrollees (3). Managed care extends coverage to preventive visits and screening, which is beneficial to vulnerable areas of populations. Part of the RAND Health Insurance experiment found that youth assigned to an HMO had a 40% greater number of routine preventive visits and 50% more office visits than a control group attached to a fee-for-service plan (4). So, conclusion factual data has shown there is no proven fact that if you use a HMO plan you are risking not receiving quality care. Personally, I use an HMO plan as it is very affordable and allows me to choose my Doctors without waiting on a referral. This type of freedom allows me easy access to transition my care from the provider to the next, which is vital in receiving a high quality of care. Choosing your healthcare plan should be tailored around what benefits you or your family.
  • 9. 4 Sandi Moore-Foggey @ 2020-05-29T15:39:42-07:00 Make sure your are double-spacing only. TITLE OF PAPER 4 References (1) Platt BD, Stream LD. Dispelling the negative myths of managed care: an analysis of anti-managed care legislation and the quality of care provided by Health Maintenance Organizations. Florida State University Law Review, 1996: 23: 489–510. (2) Miller RH, Luft HS. Does managed care lead to better or worse quality of care? Health Affairs, 1997, 16 (5): 7–25. (3) Miller RH, Luft HS. Managed care plan performance since 1980. Journal of the American Medical Association, 1994, 271: 1512–1516
  • 10. (4) Managed Care - DocShare.tips. http://docshare.tips/managed- care_574b1fccb6d87f5f2d8b4ee8.html (5) Special Theme – Health Systems Managed care: the US experience. https://www.who.int/bulletin/archives/78(6)830.pdf (6) Six major myths of managed health care By John Kingsdale July 27, 1998 Retrieved on May 24, 2020 from https://www.bizjournals.com/boston/stories/1998/07/27/editoria l2.html?page=all 5 http://docshare.tips/managed- care_574b1fccb6d87f5f2d8b4ee8.html http://docshare.tips/managed- care_574b1fccb6d87f5f2d8b4ee8.html https://www.who.int/bulletin/archives/78(6)830.pdf https://www.bizjournals.com/boston/stories/1998/07/27/editoria l2.html?page=all Sandi Moore-Foggey @ 2020-05-29T15:31:48-07:00 Please refer to the APA link on the course home page. Your references should be in alphabetical order and not numbered.
  • 11. Comment Summary Page 1 1. Omit the words, "running head". Page 2 2. You are missing the "title" of your paper. 3. Make sure to indent five spaces. Page 3 4. Make sure your are double-spacing only. Page 4 5. Please refer to the APA link on the course home page. Your references should be in alphabetical order and not numbered.