Changes in Healthcare Management

Development and Strategic Planning

The term primary health care (PHC) is commonly interchanged with primary care as if their philosophies and practices were the same. Similarly, the term health promotion is often substituted for health education especially in the general practice environment. Primary health care planning is both a philosophy and a system response to reducing health inequities and ameliorating the effects of disadvantage but strategic primary care reforms seem to have little to do with the increase in concern about health inequities as primary care is drawn from the biomedical model, practiced widely in nursing and allied health but general practice is the heart of the primary care sector. It aims to target individuals regarding disease prevention, early diagnosis and treatment. There is not much to address the socio-environmental and behavioral development and planning that underpin disease proliferation while practicing in a vertically designed medical model of primary care.

Of the approximately 257.8 million individuals currently living in the United States of America? every one of them has a need for effective? affordable and accessible health care coverage and services. Within the past thirty to forty years? the scope and cost of health care coverage and services has drastically changed? altering the manner in which health care was previously managed. There are several factors that have affected the cost of health care coverage over the course of the past two to three decades. One of these factors is the introduction and rapidly increasing enrollment in managed health care insurance plans. Managed care health insurance plans can? in most cases? help to alleviate the rising costs of effective medical coverage. Another important factor that has affected health care costs is the invention and implementation of new medical technologies.

As prominent researchers and economic analysts have discovered? there is a distinct and direct correlation between advancing medical technologies and rising health care costs. Medical innovation has been proven time and again to be an important determinant of health care cost growth. It would appear that managed care health insurance plans? which attempt to lower health care costs? and highly expensive new medical innovations and procedures are at cross purposes? pulling against one another in very different directions. Market-level comparisons have found the cost growth of health care in markets with greater managed care penetration to be generally slower than that of non-managed care health insurance markets.

Communication and Human Resources

Human resource in managed care is unlikely to prevent the share of gross domestic product spent on health care from rising unless the cost-increasing nature of new medical technologies changes. Communication and human resource in managed care health insurance plans differ greatly from indemnity fee-for-service? or FFS? insurance plans. Since the early 1970's? rapidly growing enrollment in managed care health insurance plans has transformed the health insurance market in the United States. Virtually nonexistent in most markets three decades ago? managed care health plans covered 63 percent of the nation's employees by 1994. Communication in managed care incorporates a range of features that ...