Managed Care Organizations

Managed care organizations provide health care to millions of people in the United States. Two private MCOs are Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs). These organizations have been around for decades and the HMO Act of 1973 allowed managed care to become more popular. Over the years more people have become dependent on managed care for health care needs. Although managed care has been helpful in some aspects, these organizations have been the topic of many debates.

MCOs have been stereotyped as having lower quality of care and focusing more on costs than the health care of patients. The accusation of lower quality of care could come from the idea that sometimes caregivers do not spend enough time with patients. This helps a facility see more patients throughout the day or not have enough staff to extend the amount of time with patients. Another accusation is that managed care organizations focus more on costs than helping patients. For example, there have been statements made that physicians who work in managed care organizations receive incentives for not performing certain procedures for patients. MCOs have also been known to deny claims for medically necessary treatments that could eventually lead to the further health complications or death. These are ways for MCOs to manage costs but this could cause concern for ethical issues.

It is important for MCOs to focus on the patient because these patients depend on them for health care. They want to feel that when they visit a facility they will receive good care, especially since they spend money to ensure they receive care. For those who have been treated unfairly by a MCO, these organizations have to remember their ethical practices. Patients have rights and the MCOs have keep their health the main focus. They should not put the patient's health in harm and give them the compassionate care they deserve. MCOs will be around in the future and there will be ethical issues in the future. Hopefully, they will be able to have a new approach to these issues and address them more appropriately.