Hotlist. Managed care systems: new capabilities for growing markets.
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The installation of a new administrative system is a tremendous undertaking for any organization, affecting every area of the operation. Often, because of time and budget constraints as well as the perception that change is not immediately necessary, many organizations wait until there is no option but to change systems--then make the changes under short time frames. For a large, multisite organization, the issues are the same but the complexity increases tremendously.
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Part 1 of this series organizes and discusses the sources of value against a background of an evolving managed care market. Part 2 will present, in more detail, the marketing and financial challenges to organizational positioning and performance across the four stages of managed care. What are the basic principles or tenets of value and how do they apply to the health care industry? Why is strategic positioning so important to health care organizations struggling in a managed care environment and what are the sources of value? Service motivated employees and the systems that educate them represent a stronger competitive advantage than having assets and technology that are available to anyone. As the health care marketplace evolves, organizations must develop a strategic position that will provide such value and for which the customer will be willing to pay.
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Little is known about variations in the levels of access and satisfaction within the disabled Medicare population. Based on the Medicare Current Beneficiary Survey (MCBS), beneficiaries under 65 years of age were classified by original reason for disability (mental versus physical). Those with a mental disability were less likely to have a private physician as a usual source; were less satisfied with the overall quality of care, availability of after-hours care, followup care, and coordination of care; and were more likely to report unmet need, owing in large part to supply barriers. Implications for the current delivery system and for design of managed care programs are discussed.
Over the past three decades, the long-term care community has seen continual increases in the complexity and sophistication of management information systems. These changes have been brought about by the ever-increasing demands on owners and managers to provide accurate and timely data to both regulators and financial investors. The evolution of these systems has increased rapidly in recent years as the nation attempts to reinvent the funding mechanisms for long-term care.
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