Managing managed care. The task calls for an integrated management team.
Healthcare providers must learn the art of "managing care," a concept integral to but broader than managed care. Managing care has four dimensions: recruiting skilled operations managers; developing systems, procedures, practices, and protocols that meet the demands of capitation and risk management; fully integrating physician leaders; and preserving society's resources by providing care on the wellness, rather than the sickness, model. Managing managed care, which is now usually the task of a single executive, will tomorrow require a team comprising these four roles: The CEO articulates the system's vision, helps develop its strategic plan, and leads the effort to educate all its associates and employees about managed care. The operations leader (which may in fact be a group of operations executives) redesigns the systems organizations, redeploys its managers, and dismantles its obsolete methods. The physician leader (which may also be a group, rather than an individual) helps retool the system's practices and protocols in a way that enables it to deliver the highest quality of care at the lowest possible cost. The managed care executive acts as the broker between the system and insurance firms. In larger systems, this executive designs long-term partnerships between the system and insurers.
Coleman
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Inova Health System, Springfield, VA, USA.
D002410:Catholicism; D003659:Decision Making, Organizational; D007324:Institutional Management Teams / Q000458:organization & administration*; D007857:Leadership; D008329:Managed Care Programs / Q000458:organization & administration*; D017146:Models, Organizational; D018802:Patient-Centered Care / Q000458:organization & administration*; D008486:Physician Executives; D014481:United States