Health Policy Issues

Mellissia Barrett

HCA497

Dr. Gloria Wilson

November 12, 2012

Health Policy Issues

Health care has been around since ancient times. And through the years the health care field has made many changes, splitting into different sects just as mental health, primary care, and specialty care. The cost of health care has changed and so has how we access that health care. Physicians once made house calls and now they are housed in office buildings or hospitals. Goods were once traded for fee for service providers and now people have insurance of every shape and size. Quality was a priority once, but has that held up through the years? Numerous policies have helped to shape the health care system from what it once was, to what it has become today; the following explores the viewpoints and roles of different policy makers and stakeholders on the aspects of access, cost and quality of care.

As a stakeholder, what role does a Managed Care Organizations (MCO) play when it comes to access of care? Managed care organizations are a collaboration or network of hospitals, specialists, in primary care physicians. MCO’s discourage running unnecessary diagnostic testing and treatments, use primary care Physicians to control referrals to specialists, and use case management especially for high cost conditions to encourage less expensive treatments (Turnock, 2012).

The purpose of a managed care organization is to achieve cost control by implementing aggressive cost containment mechanisms (Saunier, 2011). Medicare and Medicaid have also jumped on the bandwagon for managed care services, 13 percent of Medicare beneficiaries and 35 percent of Medicaid beneficiaries enrolled in managed care plans at the end of 1996 (Levey, 1999). This is in part because managed care services strive to contain costs, just as Medicare and Medicaid diligently