HSAC Forum Report 1998 - Laserfiche WebLink

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BACKGROUND Roughly 105* people attended the 1998 Human Services Advisory Commission (HSAC) forum, "Managed Care and Beyond: Fostering Health in Our Community. " Participants included county and state employees, representatives from human services agencies, and local legislators. Each yearly forum informs the Orange County Board of Commissioner's decision - making process and allows local organizations to meet and plan new strategies. The 1998 forum focused on the impact managed care is having on healthcare providers, patients, and service providers in Orange County and throughout North Carolina. OVERVIEW Pamela Silberman of the Sheps Center for Health Services Research made the first presentation of the morning session. She answered the question, "What is Managed Care and How will Communities be "There are two ways that managed care tries to control costs: i 1 Keeping patients healthy 2. Making sure patients don't get unneeded care" j -from Understanding Managed Impacted ? " She defined 'managed care' as "a system which helps manage the patient's care - -to ensure that the patient is receiving the most appropriate, cost - efficient form of care, " or "any product, arrangement, or entity which integrates the financing and delivery of health services for a defined population. " She explained how patients suffer both from no care and from excess care. Some statistics claim that 20 to 40 unnecessary (and even detrimental) . However, the new forms of managed care may be providing undue financial incentives to limit care. Ms* Dr* Silberman's presentation detailed some of the pros and cons of Health Maintenance Organizations (HMOs) as shown in Table 1. She also suggested that the chronically ill and the uninsured may be at most risk from the growing shift to managed care due to reduced access to needed services. She concluded that "problems exist in any healthcare system - -the goal should be to fix the problems and improve the system. " Eleanor Kinnaird contributed the "State Perspectives on Managed Care" from her standpoint as a Senator in the North Carolina Legislature. Senator Kinnaird described the grassroots effort consisting largely of citizen appeals to legislators that led to the enactment of significant consumer protections in relation to managed care plans. More information is now readily available to both consumers and the state; out -of- network care restrictions have been