Managed Health Care Program, Article Review Example

High quality care can be defined in this context as accessible care that is evidence based and technically excellent and with capacity to improve the health of children. “Technical excellence” stands for effective and efficient implementation of key processes of delivery care. On the other hand, the term “evidence based” implies support by medical evidence and or consensus from experts. Managed health care has had a great impact on the quality of health care services in United States and a big debate has been witnessed for the same. This paper analyzes an article by Bergman and Charles “managed care and the quality of children’s health services”. Special focus will be given to the problem of managed health care on children’s health and strategies applied to mitigate the issue. The paper will conclude by proposing some recommendations and stating how the article can influence practicing health care managers.

According to the article, managed health care has transformed the practice of medicine by affecting the choice of health care providers and emphasizing on cost and quality of care provided. However, the transition has failed to focus on the impact of managed care on access to quality health care services. Managed care, the article states, also lacks information about the welfare of children in the new system and fails to address their problems which existed in the traditional fee-for –service systems. The big issue therefore is that managed health care has not addressed the plight of children especially those with special needs in order for them to acquire a comprehensive and appropriate health care system.

In the managed health care system, children’s needs for a good health care system are addressed by practicing evidence-based medicine. This is being accomplished by focusing on minimizing the gap between what is known and what is done. Documentations have also been done in demonstration projects for improved health results and reduced health care costs. Insurers, who have been limiting the benefit packages for children, have also sought to improve on ancillary services and to maintain efficacious services. Other cost –conscious medical care organizations usually opt to refer children to an in-plan adult specialist who may be lacking appropriate training and expertise to handle childhood matters.

For a good managed health care system, various stakeholders including health planners, physicians, regulators, health care purchasers, and families must work together. The collaboration will foresee good brainstorming on how children can receive high quality health care. Many studies on the issue have failed to give reliable information. For instance, they fail to give a true reflection on the environment in which MCOs operate. Others have mainly focused on adults but not children’s needs. Therefore, proper documentation of rich data need to be done regarding children and managed health care programs through research. All the financial arrangements for children health care should be analyzed and with comprehensive set of quality indicators to ensure fair play. Lastly, various ways in which children can be incorporated in managed health care systems should be thoroughly researched.

This article can act as a blue print to practicing health care managers to guide the in developing a sustainable health care system for children. It can also guide them in disseminating information to the public about choosing a suitable health care scheme. Of great significance is that the article can help in motivating them to handle patients on managed health care schemes just as the others in traditional fee-for –service systems.

A good health program is important to maintain a healthy society. Managed health care system is a noble idea that if well implemented can change the country’s health sector and economy at a greater perspective. People need to be educated better on the benefits of enrolling in managed health care systems with reliance on well documented facts. A thorough research therefore is necessary to ascertain the benefits of a managed health care system since what has been previously documented portrays its negativity.