Business Commons^™

Potential Savings From Consumer-Driven Health Plans, William Ferguson, Brittany Smith, Jessica Mcnair, Sarah Miller, Bojing Wang, Alberto Coustasse

Management Faculty Research

Consumer Driven Health Plans (CDHPs) have been identified as a high-deductible insurance option that has increased consumer responsibility while healthcare expenditures have decreased. There has been an increasing need of these plans because they can help to control healthcare costs, and the increasing healthcare utilization. As the use of these plans have expanded, educated consumers have become more engaged in their healthcare services and have increased demands for transparency of healthcare costs. The methodology for this study was a literature review using 36 sources. The purpose of this study was to determine if CDHPs have created financial savings by increasing …

The Use Of Big Data By Managed Care Organizations, Bojing Wang, Xiaoying Liu, Alberto Coustasse

Management Faculty Research

Big data have become available in all kinds of healthcare organizations. The application of big data analytics in Managed Care Organizations (MCOs) has the potential to improve health care, lower costs, save lives, and help to make better-informed decisions. The study illustrated the implication of big data in MCOs. Big data can help MCOs reduce patients’ relevance, analyze specific diseases such as asthma and diabetes. Big data also could help MCOs to reduce cost after collecting data and determined the specific patients’ situation. The implication of big data has benefited MCOs in reducing costs, improving the quality of healthcare care. …

Physician Incentives: Managed Care And Ethics, Douglas A. Mains, Alberto Coustasse, Kristine Lykens

Management Faculty Research

The authors review the principle features of the managed care system in an effort to understand the ethical assumptions inherent in managed care. The interrelationships among physician incentives, responsibilities of patients and the physician-patient relationship are examined in light of the ethical concerns identified in the managed care system. The managed care system creates ethical tensions for those who influence the allocation of scare resources. Managed care's administrative controls have increasingly changed the doctor-patient relationship to the businessperson-consumer relationship. Managed care goals of quality and access demand that physicians be both patient advocate and organizational advocate, even though these roles …

The Drama Of Dysfunction: Value Conflict In Us Managed Care, Diana D. Mrotek

WCBT Faculty Publications

The transformation of the American health care environment from retrospective fee-for-service to managed care has been both rapid and chaotic. This period of change has been infected by value conflict, evoking unconscious processes in system participants as they have attempted to cope with personally threatening situations. This article attempts to elucidate this process by presenting an account of events and accompanying value conflict as it occurred over time. It also includes a systems analysis of the rapidly changing mosaic of unconscious processes that resulted from the divergent values held by the public and health care professionals, using various organization behavior …

Managed Care, Medicaid & The Elderly, An Overview Of Five State Case Studies, Robert L. Mollica, Trish Riley, Ltc Resource Center, University Of Minnesota

All U.S. Government Documents (Utah Regional Depository)

This publication contains a series of five state case studies of Medicaid managed care programs enrolling elderly care programs enrolling elderly Medicaid recipients. The case studies were prepared by University of Minnesota National Long Term Care Resource Center's two partners: the National Academy for State Health Policy (NASHP) in Portland, Maine and the Institute for Health Services Research, School of Public Health at the University of Minnesota in Minneapolis, Minnesota. These case studies have been conducted under the leadership of Trish Riley and Robert Mollica at NASHP.

The project was undertaken to examine the experience of elders in managed care, …