How effective are managed care organizations (MCO's) in improving and managing patient care?

What are some barriers that managed care organizations (MCO's) face to improve health care outcomes?

?What are some empirical research outcomes that MCO's can undertake to improve health care outcomes (population health)? 

 

Managed Care Organizations (MCOs)

Q 1

MCOs are effective for improving and managing patient care because they provide health care solutions for people that empower them to take care into their hands. For example, patients are able to access health care services at lower costs, increasing their access to adequate care (Buchmueller, Ham & Shore-Sheppard, 2016). MCOs also promote rendering immediate services for patients because staying within a network of care providers means the patients can get care and referrals to fit their needs. Therefore, MCOs place professionals in a better position to provide quality care to patients because, under a network, they store past patient data. In that sense, MCOs improve and manage care by promoting safe practice.

Q 2

One significant barrier that MCOs face when it comes to improving health care outcomes is the inability to extend their services to patients who do not have insurance or provider coverage. A large number of people in the U.S. as well as the world are not able to even enrol in the government sponsored health coverage plans. Another significant barrier is that MCOs leave patients with limited options when it comes to choosing their primary providers. Another barrier is the fact that patients complain about providers under MCO networks providing unreasonable services. Patients argue that professionals do that to try and increase the revenue they generate from insurance companies. Another challenge is the proper management of patient data contained in the network. Many patients come forward with issues pertaining to privacy infringement. 

Q 3

MCOs can further improve health care outcomes by advocating for lower healthcare costs to further increase the access to care. MCOs should concentrate on strategies that seek to expand health care options to serve the people's diverse needs. They should advocate for plans that also factor in vulnerable populations such as children, people living with disabilities, and the elderly (Buchmueller, Ham & Shore-Sheppard, 2016). They should also conduct routine surveys to ensure that health care organization maintain a culture of providing quality, safe and competent care. For example, providers are obligated to further educate patients about their health and risky behaviors to avoid. They should empower patients with health knowledge alongside information regarding their treatments.