Advances: Managed Care - Double Issue (1996)
Table of Contents:
- Family-Centered Care and Managed Care: Are they compatible? (see article below)
- Glossary of Managed Care Terms
- Children's Mental Health: Oregon managed care demonstration reduces costs, improves services
- Finding Common Ground: Diverse stakeholders share vision of the future
- Medicaid Managed Care: Families inform policy in Michigan
- Families Shaping Managed Care: How do families of children with special health care needs define quality care?
- Primary Care: Family-centered approaches for children with special health care needs
- Health Maintenance Organizations: Kaiser Permanente collaborates with parents
- Defining Quality: Developing tools to monitor care
- Making the System Work: The best and worst of managed care
- Families Affected by HIV: Can managed care work for them?
Family-Centered Care and Managed Care:
Are They Compatible?
In the last two years almost every policy meeting, journal article, and national conference related to health care for children with special health care needs has had managed care as its focus. This special double issue of Advances is no exception. In it, we begin to explore the relationship between managed care and family-centered care, especially as it relates to children with special health care needs. This examination emanates from a belief that well planned managed care systems have the potential to offer more effective and appropriate care for children with special health care needs and their families than traditional fee-for-service approaches.
In considering the relationship between managed care and family-centered care, three areas seem particularly challenging. The first, is access. Children with special health care needs typically require a broad range of specialty medical care and related supportive services. Their families also want access to support programs and services such as respite care and home health care. Are managed care programs being designed with this continuum of services in mind? If not, where will families find the services they need? What innovative solutions will program planners, clinicians, and families propose to meet this challenge?
The second area of challenge lies in the quality of the relationships between providers and families. Collaboration is at the heart of family-centered practice. Yet, developing equal, effective partnerships takes significant time. Families and clinicians must have opportunities to talk, to share information, and to develop trust in and respect for each other's expertise. How can a system designed to minimize provider-patient contact support the development of such collaborative relationships? Further, how will information, the essential ingredient for being an active partner in care and an informed decision maker, be shared with families in a managed care system? What strategies are being implemented to ensure that families' information needs are met in a cost-effective, time-efficient way?
The final challenge is to ensure that families have a substantive voice in defining quality and shaping managed care services. A family-centered system evolves from the collaborative efforts of providers and families working together to develop and evaluate policies and programs. What roles are managed care organizations developing for consumers? Are consumers advising employers about what to look for in a managed care plan? Are they helping to shape the benefits package? What is their role in monitoring quality?
In the last two decades, a tremendous amount has been learned about effective ways to organize and deliver services to children with special health care needs. The articles in this issue of Advances offer some examples of ways that families, providers, and programs across the country are working to apply that knowledge to ensure that managed care systems and organizations reflect family-centered principles and practices.
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