BUS FPX 4121 Assessment 2 External Forces and Ethical Challenges

Student Name

Capella University

BUS-FPX4121 Ethics in Health Care Management

Prof. Name

Date

External Forces and Ethical Challenges

Healthcare is significantly influenced by changes in the economy and external forces, presenting various challenges such as the demand for healthcare services, availability of providers, and facilities due to the associated costs (Morrison, 2020).

Managed Care

Managed care, established in the 1980s, aims to enhance patient care, ensure equality, and control the costs of medical services while increasing profitability (Morrison, 2020). Managed-care plans have positively impacted healthcare by offering access to services at a lower cost (Shrank, Keyser, & Lovelace, 2018).

However, these plans have limitations, including restricted provider access and referrals, which can create ethical dilemmas for healthcare professionals (Shrank et al., 2018). Despite these challenges, managed care coverage has significantly increased over the past decades (MACPAC, 2022).

Ethical Challenges in Managed Care

One of the key ethical challenges in managed care is accessibility, as limitations on medical providers can hinder the delivery of optimal treatment (Vrijhoef, 2022). Healthcare professionals must navigate ethical principles such as autonomy, beneficence, non-maleficence, and justice when faced with these limitations (Morrison, 2020).

Recommendations

Short-term strategies to address ethical concerns include providing authorizations for out-of-network providers based on patient care needs. Long-term strategies involve expanding the managed care network to increase the availability of in-network providers and facilities (Morrison, 2020).

Conclusion

While managed care has improved healthcare services, its limitations on provider availability raise ethical concerns. Expanding the network can mitigate these concerns, ensuring patients receive necessary care regardless of their health plan’s restrictions (Morrison, 2020).

References

Ethical Issues in Managed Care. (n.d.). Retrieved from https://www.amihm.org/ethical-issues-in-managed-care/

BUS FPX 4121 Assessment 2 External Forces and Ethical Challenges

MACPAC. (2022, March 10). Medicaid Managed Care Capitation Rate Setting. Retrieved from https://www.macpac.gov/publication/medicaid-managed-care-capitation-rate-setting/

Morrison, E. E. (2020). Ethics in health administration: A practical approach for decision makers (4th ed.). Jones & Bartlett. Chapters 6–7

Shrank, W. H., Keyser, D. J., & Lovelace, J. G. (2018). Redistributing investment in health and social Services—The evolving role of managed care. JAMA: The Journal of the American Medical Association, 320(21), 2197-2198. https://doi.org/10.1001/jama.2018.14987

Vrijhoef, H. J. M. (2022). The future of coordination is smart coordination. International Journal of Care Coordination, 25(1), 3-4. https://doi.org/10.1177/20534345221075661

BUS FPX 4121 Assessment 2 External Forces and Ethical Challenges