Essay about Health And Disease Management And Health Care Programs

Essay about Health And Disease Management And Health Care Programs

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Managed care programs are focused on the accuracy and reliability of patient services, care and cost. While managed care programs implement, coordinate, and plan the services, care, and cost it’s vital to consider population health and disease management. Population health and disease management have been a significant part for managed care programs for decades and ways to improve and help patients is the goal. The role of primary care physicians and specialists is very important to address the population health and disease management. Primary care physicians obtain license, college, and training to practice medicine and surgeries. Gatekeepers will be mentioned in further detail because hold significant roles in managed care for preventive services and health issues. The unique and profound history of managed care programs have been in the spotlight for decades and more details will follow subsequently.
Firstly, a detailed overview of five disease management or population health issues involving health plan coverage is needed to mention. The numerous costly chronic conditions are asthma, diabetes, congestive heart failure, coronary heart disease; end-stage renal disease, depression, high-risk pregnancy, hypertension, and arthritis have been the focus of these programs, (, 2004). As disease management as progressed over the years and has become more prevalent, it’s becoming more significant for physicians for patient benefits, coverage, and costs. Furthermore, the purpose for disease management programs is to provide better care while reducing the cost for the chronically ill, (, 2004). The other added purpose is to treat patients with affordable care and convenient cost to reduce emergency visi...

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...requires providing mental and physical benefits for patients and it’s an expanded plan in Medicaid, (Paradise, 2015). With the implementation and policy-making it’s been a huge advantage for millions of uninsured people worldwide. Another population issue associated with health plan coverage is HRA’s health reimbursement accounts which are one of the rules in the ACA. Local market circumstances may hinder the development of physician organizations as a force of innovation in managing care, (Rosenthal, Landon, & Huskamp, 2001). There needs to be better ways overcome local market conditions for the greater good of physician duties and managed care. Many insurance rates, capitation rates, and withholdings will be high depending on the region and the patient’s occupation. In addition, it all varies with each employees and how much employer contributions will be allowed.

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