Health Care Field Cost Control Methods

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My homework is entirely my own work and I did not copy from anyone else. It is very important that we utilize cost control methods in the health care field. The reason being is that about 10% of the population, usually with chronic to severe problems, use approximately 70% of the total spending (Shi, & Singh, 2008). If we didn’t monitor the costs and spending we wouldn’t be using the money efficiently. To avoid potential problems we frequently use six different cost control methods to monitor what medical services are necessary, the most cost efficient way for these services to be provided, and keep an up to date chart of the patient’s condition to offer only treatment deemed necessary. One essential aspect of cost control methods is the term referred to as gatekeeping. Gatekeeping is a process in which an individual receives care only from a primary care physician unless after being evaluated the patient receives a referral. Referrals grant you access to see specialists, hospital admittance, mental health admittance and more. Gatekeeping efficiently controls spending because rather than the average person guessing what kind of physician or treatment they need; they go get an evaluation from a skilled physician. For example, a patient could be experiencing chest pains and they could think something is wrong with their heart. This could be the case but after receiving an evaluation from a primary care physician they discover that the patient has been extremely stressed and these chest pains are severe anxiety attacks. Instead of hunting down multiple doctors they can save the confusion and get a referral for the correct doctor. Utilization management (UM) is a branch of managed care which includes gatekeeping, preau... ... middle of paper ... ... role unavoidably ran into some resistance due to families who could not afford care in a private system, and were not granted access into state facilities. The state finally runs into some weak points because legally you cannot turn down emergency services. Most of these cases are considered emergency due to the fact 80% of them are admitted involuntarily. Reference Page Bonnie, R, Reinhard, J, Hamilton, P, & McGarvey, E. (2009). Mental health system transformation after the virginia tech tragedy. Health Affairs, 28(3), 793. Merrick, E.L., Hodgkin, D., Horgan, C.M., Garnick, D.W., & McLaughlin, T.J. (2008). Changing mental health gatekeeping: effects on performance indicators. Journal of Behavioral Health Services & Research, 35(1), 03-19. Shi, L., & Singh, D.A. (2008). Delivering healthcare in america. Sudbury: Jones & Bartlett Publishers.

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