Managed Care, Nursing and Healthcare Consumers Essay

Exclusively available on Available only on IvyPanda® Made by Human No AI

Managed care refers to a set of activities that allow to reduce the cost of health care and improve its quality. Managed care techniques include the regular conduction of utilization reviews, cost-sharing, and the maintenance of provider networks. The critics accuscost-sharing care of the failure to implement the claimed outcomes, such as the higher quality and the lower costs of healthcare. At the same time, the proponents of this system argue that it contributes to the significant rise in efficiency and quality of health care services.

In this context, private insurers play a significant role in the transformation of the healthcare system. First of all, it could be noticed that the practice of implementation of pay-for-performance programs leads to the overall higher quality of services rendered by physicians and other specialists. Apart from that, according to McGinnis, Goolsby, and Olsen (2009), some of the private insurers implement the practice of encouraging the relative improvements in skills and knowledge of physician groups instead of rewarding only high absolute performance. In addition, healthcare transforms due to the implementation of “tiered drug formularies and premium networks” (McGinnis et al., 2009, p. 277). The described innovations made the patients more responsible for their treatment. That is so because the newly implemented system allows consumers to make personal and independent choices concerning healthcare. These choices are made on the ground of the desired benefits and patients readiness to incur certain risks and costs.

The role of nurses in the transformation of healthcare also under no circumstances could be underestimated. Salmond and Echevarria (2017) emphasize that the major contribution of nurses into the coinsion of healthcare is that they act as members of the interproinional team. In other words, the transition from “episodic, provider-based, fee-for-service care to team-based, patient-centered care” leads to improvements in quality and affordability of care (Salmond and Echevarria, 2017, p. 12). What is more, while private insurers are responsible for the shift from the traditional model of healthcare to the pay-for-performance system, it is in the interest of nurses to provide the patients with efficient, safe, and timely medical care.

Finally, it is essential to mention that the responsibilities of nurses are not limited by the bedside care of the patients. Nurses could also contribute to the reduction of costs of the provided healthcare services. One way to achieve this goal is to analyze the symptoms and test results more carefully so as to get rid of some unnecessary medications. The idea is that nurses should assist physicians with the decision-making procedure and diligently report the symptoms, complaints, and changes in health status. The second idea is that nurses might improve communication with the managerial personnel and give them recommendations on the presence and absence of some supplies. This way, they could minimize the spending on purchases of some necessary supplies that might be stocking for a while. Minimized expenses usually lead to lower costs for healthcare.

To sum up, nurses play an essential role in the improvements in healthcare. It is not enough to change the paying strategy or implement some of the managed care techniques. For healthcare to be improved, nurses should act as the leaders who are responsible both for clear communication with the administration and for the provision of decent care for the patients.

References

McGinnis, J. M., Goolsby, W. A., & Olsen, L. (2009). Leadership commitments to improve value in health care: Finding common ground: Workshop summary. National Academies Press.

Salmond, S. W., & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopedic nursing, 36(1), 12-25.

More related papers Related Essay Examples
Cite This paper
You're welcome to use this sample in your assignment. Be sure to cite it correctly

Reference

IvyPanda. (2022, February 25). Managed Care, Nursing and Healthcare Consumers. https://ivypanda.com/essays/managed-care-nursing-and-healthcare-consumers/

Work Cited

"Managed Care, Nursing and Healthcare Consumers." IvyPanda, 25 Feb. 2022, ivypanda.com/essays/managed-care-nursing-and-healthcare-consumers/.

References

IvyPanda. (2022) 'Managed Care, Nursing and Healthcare Consumers'. 25 February.

References

IvyPanda. 2022. "Managed Care, Nursing and Healthcare Consumers." February 25, 2022. https://ivypanda.com/essays/managed-care-nursing-and-healthcare-consumers/.

1. IvyPanda. "Managed Care, Nursing and Healthcare Consumers." February 25, 2022. https://ivypanda.com/essays/managed-care-nursing-and-healthcare-consumers/.


Bibliography


IvyPanda. "Managed Care, Nursing and Healthcare Consumers." February 25, 2022. https://ivypanda.com/essays/managed-care-nursing-and-healthcare-consumers/.

If, for any reason, you believe that this content should not be published on our website, please request its removal.
Updated:
This academic paper example has been carefully picked, checked and refined by our editorial team.
No AI was involved: only quilified experts contributed.
You are free to use it for the following purposes:
  • To find inspiration for your paper and overcome writer’s block
  • As a source of information (ensure proper referencing)
  • As a template for you assignment
Privacy Settings

IvyPanda uses cookies and similar technologies to enhance your experience, enabling functionalities such as:

  • Basic site functions
  • Ensuring secure, safe transactions
  • Secure account login
  • Remembering account, browser, and regional preferences
  • Remembering privacy and security settings
  • Analyzing site traffic and usage
  • Personalized search, content, and recommendations
  • Displaying relevant, targeted ads on and off IvyPanda

Please refer to IvyPanda's Cookies Policy and Privacy Policy for detailed information.

Required Cookies & Technologies
Always active

Certain technologies we use are essential for critical functions such as security and site integrity, account authentication, security and privacy preferences, internal site usage and maintenance data, and ensuring the site operates correctly for browsing and transactions.

Site Customization

Cookies and similar technologies are used to enhance your experience by:

  • Remembering general and regional preferences
  • Personalizing content, search, recommendations, and offers

Some functions, such as personalized recommendations, account preferences, or localization, may not work correctly without these technologies. For more details, please refer to IvyPanda's Cookies Policy.

Personalized Advertising

To enable personalized advertising (such as interest-based ads), we may share your data with our marketing and advertising partners using cookies and other technologies. These partners may have their own information collected about you. Turning off the personalized advertising setting won't stop you from seeing IvyPanda ads, but it may make the ads you see less relevant or more repetitive.

Personalized advertising may be considered a "sale" or "sharing" of the information under California and other state privacy laws, and you may have the right to opt out. Turning off personalized advertising allows you to exercise your right to opt out. Learn more in IvyPanda's Cookies Policy and Privacy Policy.

1 / 1