What Is The Link Between Managed Care Healthcare And Business Risk

Proper healthcare facilities are the right of every citizen. Over the years the government has devised programs that try and provide the best possible healthcare services to its citizens. The managed care healthcare program is one such program that was started by the government to provide better healthcare facilities to the people at a very small fee. Different healthcare programs like the health management organization, point of service managed care, preferred provider organization etc. have over the years been successful programs that help people with all their healthcare needs.

A managed care healthcare program is one in which people who want to get enrolled pay a small amount of money as fees. Everyone who has been enrolled gets access to a number of elite doctors who are in the panel of the managed care program.

These doctors provide their services to the program for a small fee and for benefits that they get from the government. This creates a win-win situation for both the patients and the doctors.

This model called as the managed care model has developed with different variants over a period of time. All these models have only slight differences as compared to the basic program of managed care. For example in IPO – Independent Practitioners Organization, the doctors who are on the panel are allowed to work on their own private practices too.

The managed care program is a very good program for everyone involved but it does has a few pitfalls. The program can work only when a large number of people agree to joining it.

But we must also remember that if everyone who joins also suffers from some or the other disease, then the whole program will turn unviable. The risk increases with every person that joins and not letting them join means hampering the growth of the program.

Under such circumstances a proper risk management strategy is required to ensure that the program works and the risks inherent to it are all managed well. In order to let this happen, financial risk management strategies need to be applied to the managed care healthcare program after it is implemented.

The managed care healthcare program has been successful, and yet it has had its detractors too. The debate whether this program is as cost effective as it is claimed to be is still alive. This is because studies have shown that this program has actually increased the patient’s cost of care by nearly 25-30%.