What’s Managed In Managed Care. Part 2

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Managing utilization is a little more difficult to measure, due to the fact that costs are indeed involved. However, after a long period of thinking that over utilization (or excess use)of services was costly, we now know that both over and under utilization of services is wrong and costly in the long run. I frequently correct people by using the expression “appropriate utilization” to mean the delivery of services in the most efficient manner. If a doctor sees a patient in the office frequently, thereby avoiding the use of a more costly hospital stay, that is appropriate utilization. It is the over use of less costly services to save higher costs in the long run.

Access to services such as appointment times, appropriate diagnostic procedures, and wellness visits have been made more available through managed care. These items as well as others are measured and reported to businesses through a company called the National Committee for Quality Assurance. By measuring, reporting, and improving these things, we have hopefully created easier access to the health care system. If one can’t get into the doctor’s office in the first place. There is an obvious lack of any utilization!

Most importantly, managed care has helped to transform our system of medicine from an illness based system to a one which is wellness oriented. Through the measurement of immunization rates, mammography, and routine physical exams, we have finally come to realize that it is a lot less expensive to pay to keep people well, than to treat them when they get sick. Since managed care programs pay for wellness and indemnity insurance doesn’t, it’s apparent which will be the better and cheaper system in the long run.

The new delivery systems (HMO,PPO,and others) have it’s share of problems, but I think we are headed in the right direction; that is, from a system that treats illness to a system that helps prevent it.

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