Health Insurance Helps With Managed Care

By Author: Andy Smith
Total Articles: 13
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Managed care is one of the new terms which people are listening in India. Managed care is not just a term used, but it is a system which has been designed to reduce the cost of increasing health care and health insurance system in India. Managed care is ideally suited to Indian conditions more than anything else due to the lack of world class health care services and due to the higher cost of conventional medical treatments.

Managed care intends to surpass unnecessary costs involved in conventional health care in the form of incentives to physicians and patients who adopt alternate medical treatments, increase in cost sharing of beneficiaries, decrease in the inpatient admissions and unnecessary stay in the hospitals, cost sharing for outpatient surgery, contracts with low cost health care providers, etc and many more. All these incentives are being provided under managed health care systems which are being introduced in India after the system’s success in western countries.

The main intention of introducing such a system ...
... into health care system is to cut down the cost of delivering health care and at the same time to increase the quantity and quality of health care system. This system has been introduced to tackle the issue of rising costs of health care in India in the past few years.

Lately, medical insurance companies have been recognizing alternate schools of medicine and they have started encouraging such schools of thought such as Ayurveda, Unani, Homeopathy, Siddha, Aromatherapy, etc through their health insurance and mediclaims programs. By encouraging these alternate medical practices, they intend to bring down the number of claims. It is believed that by introducing managed care into the health care and health insurance sectors, they can in fact, bring down the number of claims by around 10% to 30% in the coming few years.

On the other hand, there have also been critics for managed care introduction in India. They argue that with the introduction of managed care and encouragement being given to doctors and medical practitioners to introduce alternate treatments can be a dangerous move because of the lack of proper diagnostic methods in these alternative treatments. Apart from this, even conventional doctors, as they say, would be turned into preferred providers and get more patients through the managed care network. Another argument against managed care is that doctors are not encouraged to refer specialists to the patient for early diagnosis, increasing the risk of contracting diseases without proper and early diagnosis.