Question

Managed care attempts to provide incentives for more efficient use of health care resources by doing all of the following except:

⦁ Defining and managing provider networks

⦁ Engaging in utilization review of providers

⦁ Allowing patients access to specialists of their choice

⦁ Creating clinical guidelines and reminder systems for physicians

Answer 1

Answer: 3^rd option; allowing patients ….

Managed care (MC):

This is an insurance plan concerning to health that has contract with service providers for providing medical facilities to patients at a reduced cost. Insurers have sufficient networks, review systems, and guidelines for physicians in order of efficient use of resources; but, the access of patients to specialists according to their choices is not a part of it. Actually patients are not resources; they are customers; therefore, their choices may create clumsy – doctors may be already busy or occupied for attending any further call.