Advantages and Disadvantages of Managed Health Care

Advantages and Disadvantages of Managed Health Care

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Advantages

The aim of managed care is to keep health care costs down without sacrificing quality, and they have accomplished this by contracting health care providers and referring these to their enrolled members to avail of services and procedures at a discounted rate. This type of health care is most attractive for employers who seek to provide medical care benefits to their employees without having to shoulder exorbitant fees.

Disadvantages

The other side of the coin when it comes to managed care for some members is the rigidity of rules concerning the choice of health care providers, which is especially true for HMOs. In some cases, a member may not be fully satisfied with the care that is given by a primary care physician and would want to consult with another who is not included in the network available through their managed care provider. The only recourse would be to do so and pay the expense in full out-of-pocket. There are those who complain and speculate that in order to save money, their managed health care provider contract inexperienced, less-educated doctors and health professionals. Others have reported that for the sake of saving money, their primary care physicians skip on the tests necessary for members to go through in order for their conditions to be properly diagnosed. On the opposite side of this spectrum are those who complain that their primary care physicians make them go through unnecessary treatments and tests for their condition in order for them to make more money.