What are some of the ethical issues when managed care organizations are involved?
A managed care organization, by definition, is an organization that practices managed care principles. It is a health plan or health company which works to provide quality medical care at a cost-effective price. Healthcare organizations include providers such as hospitals, doctors and other medical professionals and facilities who work together on behalf of patients. Managed care refers to resolutions that assistance to save money on healthcare while providing better services for patients. While employed in the business department of the hospital the majority of insurance payors comes from managed care and includes provider networks that involve providers agreeing to specific standards and costs. In addition, managed care focuses on deterrence and managing resources and utilization to help patients while reigning in costs. Managed care plans usually offer a lower premium and require less paperwork. However, the choice of physicians, drugs, and treatment are restricted.
Ethical concerns that managed care raises are financial incentives that are frequently used to affect physician behavior and may include rewarding physicians who practice medicine sparingly by offering financial rewards, such as bonuses, for those who provide the most cost-efficient care. Those who perform too many procedures or are cost-inefficient in other ways may be penalized, often by concealing bonuses or percentages of income. Nonmonetary incentives to maximum care take the form of bringing pressure from superiors. These monetary and nonmonetary incentives raise the ethical concern that physicians may negotiation patient advocacy in order to achieve cost savings.
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