How can managed care organizations promote preventive care?
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Preventive care is the practice of avoiding or reducing the risk of developing chronic diseases and health problems through regular screenings, vaccinations, counseling, and lifestyle changes. Preventive care can improve the quality of life and reduce health care costs for individuals and populations. However, many people do not access preventive care services due to various barriers, such as cost, lack of awareness, or low priority. Managed care organizations (MCOs), which are health care delivery systems that coordinate and control the use and cost of health care services for their enrollees, have a key role to play in promoting preventive care. Here are some strategies that MCOs can use to encourage and facilitate preventive care among their members.
One way that MCOs can promote preventive care is by providing incentives and benefits for their enrollees to use preventive care services. For example, MCOs can offer lower copayments, coinsurance, or deductibles for preventive care visits, or waive them altogether. MCOs can also reward enrollees who complete preventive care activities, such as screenings, immunizations, or health assessments, with cash, gift cards, discounts, or other perks. Additionally, MCOs can design benefit packages that cover a comprehensive range of preventive care services, such as cancer screenings, diabetes tests, smoking cessation programs, and mental health counseling, and align them with the recommendations of the U.S. Preventive Services Task Force (USPSTF).
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Annemarie Viegas
Nursing Supervisor at Prime Hospital
Following international health calender, services can be offered at institutions at reduced costs : Like world heart day-cholesterol check ups Diabetes day -blood sugar chek ups October- breast cancer month -mammograms TB day - Lung x rays Of course the marketing department have to advertise the events to motivate the community to take part in the check ups.
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Kavita Atul Singh
Data Analyst | Healthcare | Business Analyst | Project Management | Public Health
Managed Care Organizations can leverage technology to provide their members with tools and apps that help them track and manage their preventive care activities, such as vaccinations, screenings, and wellness check-ups. They can use telehealth services for providing preventive care. Managed care organizations can use data analytics to identify high-risk individuals and predictive modeling to anticipate and address health issues. Managed care organizations can advocate at legislative levels for policies that support preventive care and create a positive environment for preventive care.
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Another way that MCOs can promote preventive care is by educating and engaging their enrollees about the importance and benefits of preventive care. For example, MCOs can send reminders, alerts, or notifications to their enrollees via phone, email, text, or mail about their due or overdue preventive care services, and provide information on how and where to access them. MCOs can also use social media, newsletters, websites, or apps to share relevant and evidence-based information on preventive care topics, such as the risks and symptoms of common diseases, the effectiveness and safety of vaccines, or the tips and resources for healthy living. Moreover, MCOs can involve their enrollees in decision making and goal setting for their preventive care plans, and provide feedback and support along the way.
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David Beaumont
Occupational Physician and Author at Positive Medicine Ltd
What if we (as healthcare professionals) have forgotten what prevention can be? As a doctor, my training 40 years ago taught me that disease prevention has three tiers: 1. Primary Prevention: I’m fit and healthy and want to stay that way, or get fitter and healthier (It’s difficult to get people to engage at this level - it feels too far away until health deteriorates) 2. Secondary prevention: early intervention. Things have started to slip. Maybe I’ve a bit overweight, a bit of blood pressure, a bit of cholesterol or blood sugar and I want to reverse that 3. Tertiary: I’ve had a heart attack. Stroke. Cancer. Diabetes. I want to live my life to the full despite that The real opportunity is secondary prevention. Empowering behaviour change.
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Hesham Mousli
Healthcare Quality & Patient safety consultant, Health economics professional, PhD. Biomedical informatics & Medical statistics.
In the current direction of the pay for performance approach, I think empowering healthcare beneficiaries to speak up and planning for a comprehensive healthcare educational program may be a magical solution to effectively establishing the concept of preventive care. The unprecedented evolution of communication means made it easier to target various population segments according to the desired public health objectives.
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A third way that MCOs can promote preventive care is by partnering with providers and community organizations that deliver or facilitate preventive care services. For example, MCOs can collaborate with primary care providers, who are the main source of preventive care for many people, to ensure that they follow the best practices and guidelines for preventive care, and to reimburse them adequately and fairly for their services. MCOs can also work with specialty providers, such as dentists, optometrists, or podiatrists, to coordinate and integrate preventive care services across different domains of health. Furthermore, MCOs can network with community organizations, such as schools, churches, or nonprofits, to reach out to and serve diverse and underserved populations, and to address the social determinants of health that affect preventive care access and outcomes.
Preventive care is a vital component of health care that can benefit both individuals and populations. By using these strategies, MCOs can promote preventive care among their enrollees and contribute to the improvement of health care quality and efficiency.
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Sanjoy Choudhury
Additional Chief Medical & Health officer, Goalpara
MCO should work out plan to work with influential people,NGO,Religious leader, political people, academic organisation to give input to the community for preventive measures like councelling, vaccination,life style diseases knowledge,NCD screenshot etc.
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Max Anfilofyev
Helping healthcare companies thrive | Head of Product @ DR | Follow me for tips on succeeding in VBC
To ensure patients adhere to preventive care, Managed Care Organizations must tackle barriers head-on. From food insecurity to medication costs, addressing these real-life issues can dramatically increase compliance. Key factors influencing patient engagement include ease of access, competing life responsibilities, financial constraints, and emotional and cultural considerations. Proactively supporting patients in these areas isn’t just good practice—it’s a cornerstone of effective managed care.
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Sanjoy Choudhury
Additional Chief Medical & Health officer, Goalpara
There are some areas of Goalpara district which are having resistant groups of people for vaccination.They don't believe in vaccination as a preventive measures.Hence it is very difficult for front line health workers to vaccinate those people.