Special Populations Paper

Special Populations Paper

As a case manager, not only do you deal with different populations daily you also assist elderly individuals to manage and defeat their problems. This can become a demanding task that involves diligence, accountability, integrity, and morals. Simultaneously, it is an intriguing way of making a difference in the lives of clients as well as gives them a piece of you and all the education you have learned to help provide valuable resources for their benefit. Fortunately, many case managers have researched, worked, and experimented for years on managed care, but my goal would be to add my own personal touch to helping the elderly and their concerns. Thanks to them we now have the opportunity of choosing between a variety of models and concepts that fits into each client's circumstances or problems, and offer in this way a more professional service.

Managed care is taking over as the predominate method of financing mental health care in the United States (Holmes, 1997). I have expressed interest in managed care of the elderly due to policies set to develop workable managed care solutions for the problem of rising health care costs which is traced back to the Nixon era (Brown, 2000). Since that time, the development of managed care has hinged on a seemingly paradoxical promise of offering quality care that is accessible, while at the same time keeping costs within prescribed constraints (Brown, 2000). Health care expenditures in the United States have risen dramatically over the past five years, leading to increases in health insurance premiums (Davis, 2003). Back in the late 1980's and early 1990's, employers responded to rising premiums by turning to managed care policies (Davis, 2003). The backlash against managed care in the 1990's was primarily driven by the powerful concern of patients and policymakers over the idea that those who pay for healthcare services could override the decisions of clinicians and patients regarding diagnosis, treatment, and specialist referral (Tunis, 2004). However, recent trends show that managed care coverage is declining and employers, instead, are choosing policies which shift more health care expenses onto workers (Davis, 2003). The shift to managed care financing provides a unique opportunity to raise the importance of health outcomes as the true mark of quality in managed care. A widespread fear that managed care organizations are too ready to reduce quality for increased profits has led to a current national criticism against managed care. Instead of only viewing health plan members as recipients of medical services, health plans should also view members as a population group with subpopulations within them, needing both medical and nonmedical services to improve their health (Armstead, 1999).

Despite an 8 percent to 9 percent projected rise in annual health care costs, employers' concerns about these rising