As Simple as “I do, we do, you do”?
Everyone who works in healthcare, whether it’s the janitor or the physician, the nurse or the social worker, the dietary aid or the occupational therapist, is there to help people. Yet everyone who works in healthcare is aware that there are major problems in the system. People who need care are not getting it, even with the Affordable Care Act.
Health plans have stepped up to the plate to participate more actively in assuring that people who need care get it. People like case managers, care coordinators, community health workers, patient navigators, and more, have been added to teams within insurance companies, community health agencies, HMO’s, and others who provide care coverage, to be the key ingredient in making sure people get the care they need.
Managed care is today’s prevalent model for managing the process for delivering health care and managing its costs. Payers and insurers no longer simply write checks to pay for health care services ordered by a physician; they become involved in decisions about how much care a patient receives, what kind and by which providers.