Strategic Management in Health Care

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5 October 2008

Strategic Management in Health Care

Managed Care Organizations

Managed care is the of various ways that are proposed to reduce the expenditure of providing health care benefits and excelling in the quality of care and these techniques are used by the organizations that provide the people with health care services are called managed care organizations . Managed care organizations help to reduce the health care expenses by giving different kinds of incentives

These incentives can be for the doctors and patients to choose the health care plans that are not so costly and benefits for sharing the expenses of health care and controlling the lengths of stay at the hospital can also be given

The HYPERLINK "http /en .wikipedia .org /wiki /Health_Maintenance_Organization_Act_of_197 3 " \o "Health Maintenance Organization Act of 1973 " Health Maintenance Organization Act of 1973 further boosted the growth of managed care in the United States that was initiated by health maintenance organizations . There are four different types of management care organizational plans are mentioned below

Utilization Management Plan

This is the assessment of the suitability of medical needs and efficiency in the HYPERLINK "http /en .wikipedia .org /wiki /Health_care \o "Health care " health care services measures as well as the amenities . These are offered that have to match the requirements of the appropriate HYPERLINK "http /en .wikipedia .org /wiki /Health_benefits \o "Health benefits " health benefits plan . The procedures included in utilization management is the planning that is involved before the discharge and besides other types of plans there are many other processes that utilization management covers that includes concurrent clinical and HYPERLINK "http /en .wikipedia .org /wiki /Peer_review " \o "Peer review " peer reviews and the requests of the provider , payer or patient are also considered

Purpose of Utilization Management and its Components

The purpose of utilization management is to efficiently manage the health care cases . This has to be taken care of both before and after the services have been rendered . It consists of various processes and these processes are mentioned below

Disease Management

A strategy of providing the health care services using interlinked clinical teams that also analyze appropriate data continuously using cost-effective technology is disease management that also facilitates in improving the health care results of patients who have some particular diseases and comprises of self-care management techniques as well as educates the patients , and also provides training . Plans are provided to the patients on individual basis and clinical guidelines

Purpose of Disease Management

To reduce the costs involved in health care as well as the quality of life of the people chronic diseases . This is done by preventing or at least reducing the effects of a particular disease

Elements of Disease Management

Business cases are used to classify the economic and health outcome benefits , however , it is important that they are properly verified . CDM structured collaborative are necessary for training and support and teams led by doctors while...