Managed Care Paper

Managed Care Paper

Managed Care and Case Management Care
                                                    Marvin Lloyd
                                      BSHS/402-Case Management
                                                27 August 2012
                                                  Virgil Miller

Managed Care are techniques employed to help reduce the cost for providing health benefits and a system for improving organizations quality of care. The United States National Library of Medicine describes managed care as, “programs that are intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases” (National Library of Medicine). Manage care has presented many issues for social service workers that include ethical responsibilities to the clients. These ethical responsibilities include self-determination, informed consent, competence, conflicts of interest, privacy and confidentiality, and the interruption and termination of services (Apgar, 2000). Manage care companies may attempt to contain cost by limiting the types and length of certain covered treatments. According to, Ethical Issues and Dilemmas for Social Workers Practicing in Managed Care Environment, “Often in the manage care environment, social workers may feel pressure to serve those who cross their paths. The social service professional must be aware that ethical violations occur when social service workers agree to practice utilizing treatment models in which they have not been adequately trained (Apgar 2000, p. 96)
Case management care occurs when the...

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