Evolution of Managed Care Paper

Managed care is a health care system that has been around, in this country, for decades. It was created to help cut the cost of health care benefits while simultaneously improving how patients and their families receive health care. Managed care is meant to offer benefits, specifically to the health care providers, for offering cost efficient treatment options to patients; thus making health care affordable to the patients who are enrolled in this type of program. Managed care is also meant to stream line treatment, ensuring that patients only endure what is absolutely necessary; both financially and physically. Managed care, however, could not work alone it required the use of HMOs (Health Maintenance Organization).

Managed care can actually be traced back to the 1930’s where doctors offered medical treatment to certain employees of companies at a prepaid basis; specifically a Dr. Garfield. In order for this to bring in an income to him, he had an agreement stating he would be paid a percentage of the money from the insurance company for treatment rendered. Once this sort of practice’s success spread to others, so did the appeal of the prepaid basis. Eventually this spread from shore to shore, all over the United States. As the appeal was spreading, so was the competition in the form of additional managed care programs.

As managed care was growing two additional forms of managed care were developed in the 1950s. The two additional forms were known as IPA (individual practice associations) and network model HMOs. These permitted the physicians to see more patients, not just those who were covered by a specific company. These patients would also not find themselves having to pay out of pocket up front for treatment. This brought money to the physicians regularly on a pre-arranged pay schedule, sometimes in the form of monthly pay schedules. Though, some felt this could be expanded on to help the physicians, the insurance companies, and the patients.

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