Managed Care Companies - Are Your Loved-Ones Safe in Their Hands?

What are managed care companies?

A managed care company refers to any arrangement for health care in which an organization, such as a Health Maintenance Organization (HMO), another type of doctor-hospital network, or an insurance company, acts an intermediary between the person seeking care and the physician.

Why we have managed care companies


From the middle 1980s to the present, health care costs have continued to rise at a great pace. The health care industry was unable to maintain manageable medical care costs. This led to the creation of managed care, in which third-party payers try to limit costs by managing your access to health care.

Methods of cost control

Some of the cost-management tactics are:

· Doctors prescribing only certain “approved” drugs · Limiting the length of “approved” hospital stays · Preauthorizing hospitalization or surgery · Visiting your “primary care physician” before being referred to a specialist · These are requirements and if you don’t’ follow them, your costs may be covered only partially, by your health insurance company, or not at all.

Are these cost-controlling measures beneficial?

Good things to come from these measures include improved parking at managed care facilities; better tasting hospital food; using business practices and information technology in the health care setting; and moving medical procedures and treatments to less costly facilities when possible.

Are there disadvantages to cost-controlling measures which might compromise the safety of my loved ones?

Many people feel that the severe weaknesses inherent in managed care outweigh the potential benefits.

There is a serious trust issue concerning doctors who either work for the third party organization or are motivated by insurance reimbursements. How can these doctors provide the high quality of health care you deserve when they are restricted by managed care rules or lower reimbursements from insurance companies for certain treatments? Even though these doctors are somewhat in the middle, the losers in these situations are the health care patients themselves, or your loved ones.

Examples of cost-controlling measures that end up reducing the quality of treatment:

· Making physicians choose lower-cost, shorter treatment methods (remember cheaper doesn’t always mean better)· You or your loved one’s privacy being put at risk by relaying information between your health care provider and the managed care company· Health care plans prescribing anxiety medications as an alternative to paying for psychotherapy· Suicidal patients who have nowhere else to go because they have finished their allowance of therapy sessions

As you can see, sometimes managed care companies will offer you or your loved ones reduced-cost care instead of quality health care. If you or a loved one has received what you feel is unsafe care in the hands of managed care companies, contact us and we will connect you with one of our experienced managed care lawyers today.

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