Care Management, who’s in charge?

Prior to 1973, the idea of managing the care of individuals was relatively uncommon. People in the United States were able to obtain care easily, with little financial oversight and at minimal cost.

In 1973, the growth of managed care began with the enactment of the Health Maintenance Organization Act. In an attempt to reel in the rising costs of health care, and promote for-profit competitiveness, the “HMO” was put into law and the era of cost-constrainable health care was born…or at least that’s what was hoped for.

Since that time, the direction of health care cost containment has moved more towards monitoring the allocation and use of health care dollars, with the oversight for the utilization of services being handled by health care institutions and the insurance industry. While flagrant abuse of health care resources has diminished, and a pro-active approach towards health care delivery have resulted Рto some degree Рthe general public has become increasingly disempowered in how they can or cannot access their health care benefits.

The concept of personal care management is not new. Within most hospitals, there are case managers who are charged with overseeing and managing the care of patients, ensuring or at least trying to ensure that patients get the care and attention that they need. Much of this pro-active focus is aimed at reducing costs and optimizing the provision of care. What results, more so in the setting of primary care (doctors’ offices) is that health care providers must attend to larger numbers of patients in the least amount of time possible.

The results of having our care managed by hospitals or doctors’ offices, or even by our insurance companies, are that we are less likely to receive all of the care that we need, and are more likely to “fall through the cracks” when it comes to really managing our care.

What can you do, now, to make sure that your care is the best that you can get and all that you deserve?

The first thing to do is to take charge by realizing that you need to become active in your care and in its management.

As consumers of health care, we’ve come to expect that we can stand back and let the providers of our care manage our care. Wrong. We’ve been lead to believe that the companies who do manage our care always have our best interests in mind. Wrong. We’ve bought into the idea that we can treat our bodies in whatever manner we choose and then let the health care system fix it, like a mechanic fixes a care. Wrong.

We need to step up and take charge of our care by taking care of ourselves. That means that when we receive a new prescription from our doctor, nurse practitioner, or physician’s assistant; we ask them about the medication and are familiar enough with our other medications to tell them what we’re taking. It also means that when or if we find that we are taking increasing numbers of medications, we schedule an appointment to meet with our primary care provider to discuss our medications to see whether they are compatible.

There are many ways that we can remain actively engaged in managing our care. I’ll add more ideas in coming posts. Please stay tuned!

0 Comment   |   Posted in blog July 17, 2012