What Is The Impact Of Case Management On Medical Cost Reduction In Healthcare Companies?

Muma Business Review Pub Date : 1900-01-01 DOI:10.28945/4396
Freda Chibuta Brazle
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引用次数: 1

Abstract

For healthcare insurance companies, managing and reducing medical costs is important to remain viable and/or meet investors and stakeholder expectations. The accountability to minimize costs and remain competitive becomes a responsibility for managers who work in these companies. Therefore, managers must continually look for methods to identify and implement opportunities that improve case management business processes. In this research study, the focus is on the question ‘what is the impact of case management on medical cost reduction in healthcare companies? This is asked within the context of business processes and leverages the four principles of Taylor’s scientific management theory. By investigating the relationship between case management processes in healthcare insurance companies and medical costs, the integrated synthesis uncovers that although evidence exists that case management does reduce medical costs, there is insufficient research on how to improve case management processes. There is an opportunity to provide recommendations on approaches and techniques to improving case management processes to reduce medical costs. Improving case management processes should include quantitative analysis. The proposition is that as case management processes improve and become more efficient, and when targeted against the right population, medical costs for healthcare insurance companies are reduced thereby improving the financial position of healthcare insurance companies. Therefore, managers who understand and know how to improve case management processes in healthcare insurance companies contribute more towards the financial position than companies who do not have the right management.
案例管理对医疗保健企业降低医疗成本有何影响?
对于医疗保险公司来说,管理和降低医疗成本对于维持生存和/或满足投资者和利益相关者的期望非常重要。降低成本和保持竞争力成为在这些公司工作的管理者的责任。因此,管理人员必须不断寻找方法来识别和实现改进案例管理业务流程的机会。在本研究中,重点是在问题“什么是个案管理对医疗保健公司的医疗成本降低的影响?这是在业务流程的背景下提出的问题,并利用了泰勒科学管理理论的四个原则。通过调查医疗保险公司的病例管理流程与医疗成本之间的关系,综合综合发现,尽管有证据表明病例管理确实降低了医疗成本,但如何改进病例管理流程的研究不足。有机会就改进病例管理程序以降低医疗费用的方法和技术提出建议。改进病例管理程序应包括定量分析。其主张是,随着病例管理流程的改进和效率的提高,以及针对合适的人群,医疗保险公司的医疗费用就会降低,从而改善医疗保险公司的财务状况。因此,了解并知道如何改进医疗保险公司病例管理流程的管理人员比没有正确管理的公司更有助于改善财务状况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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