PSI Ohio Insurance Practice Exam

Managed care plans increase efficiency by all of the following means EXCEPT?

1. Overseeing the standard of care

2. Negotiating prices with providers

3. Enhancing preventive care

4. Transferring management of costs to the insureds

The correct answer is: Transferring management of costs to the insureds

Managed care plans are designed to control healthcare costs and improve the quality of care by implementing various strategies. The correct answer, which indicates what does not contribute to increased efficiency, is the transfer of management of costs to the insureds. Managed care plans aim to reduce costs and enhance care through direct oversight and negotiation. By overseeing the standard of care, these plans ensure that patients receive appropriate and effective treatments, thus avoiding unnecessary procedures that could drive up costs. By negotiating prices with providers, managed care organizations secure lower rates for services, which directly contributes to cost control and efficiency. Additionally, enhancing preventive care helps in identifying and addressing health issues before they escalate, ultimately reducing the need for more expensive treatments later on. The transfer of cost management to insured individuals, on the other hand, does not inherently increase the efficiency of the plan. In fact, it can result in higher costs for the insured without ensuring a corresponding increase in the quality or efficiency of care. When costs are shifted to individuals, it can lead to delayed care due to financial constraints, which may ultimately increase overall healthcare costs rather than contain them. This approach contrasts with the primary goals of managed care, which focus on systematic control and reduced expenditures while improving care delivery.