Managed care is a term used in healthcare systems to describe a type of health insurance plan that promotes cost-effective healthcare by controlling the utilization of medical services. The spelling of the word "Managed Care" is represented in the IPA phonetic transcription as /ˈmænɪd ˌker/. The first syllable is pronounced with a short 'a' sound, and the stress falls on the second syllable. The 'g' in "managed" is silent, and the vowel sound in "care" is represented by the schwa symbol, /ə/.
Managed care is a comprehensive healthcare delivery system that aims to improve the quality, efficiency, and cost-effectiveness of healthcare services. It is a method of organizing and coordinating healthcare services, typically provided by insurance companies or other organizations, with the goal of managing healthcare utilization and costs while ensuring the delivery of high-quality care.
In managed care, a network of healthcare providers, including physicians, hospitals, and other healthcare facilities, is contracted by the insurance company or organization to provide care to a specific group of individuals, known as enrollees or members. These healthcare providers agree to provide services at negotiated rates and adhere to certain guidelines, such as the use of evidence-based practices, preventive care measures, and cost-effective treatment options.
Managed care typically involves the use of primary care physicians as gatekeepers, who coordinate and authorize referrals to specialists and other healthcare services. This approach helps to control costs and prevent unnecessary utilization of healthcare resources.
The key features of managed care include utilization management, which involves reviewing and approving the medical necessity of services; case management, which focuses on coordinating care for individuals with complex or chronic conditions; and disease management, which aims to provide comprehensive care and support for individuals with specific chronic conditions.
Overall, managed care is designed to provide a structured and coordinated approach to healthcare delivery, focusing on preventive care, cost-efficiency, and improved health outcomes for enrollees.
The word "Managed Care" originated in the United States in the late 20th century with the establishment of healthcare systems to control rising medical costs. It is a compound term consisting of two main components:
1. Managed: The word "managed" originates from the Old English word "mannian", which means "to manipulate, control, or handle". Over time, "mannian" evolved into the Middle English word "manage", which acquired the meaning of "to control, govern, or handle". The term "managed" in the context of healthcare refers to the control and organization of various aspects of health delivery.
2. Care: The word "care" traces its roots to the Old English word "caru" and has remained largely consistent in its meaning. It refers to the provision of attention, treatment, or concern for the well-being and health of individuals.