Ethical Implications of Administrative and Organizational Decisions

Ethical Implications of Cost Control Measures in Managed Care Organizations
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Ethical Implications of Cost Control Measures in Managed Care Organizations
Managed care organizations (MCOs) shape current healthcare delivery and balance excellent treatment with rising healthcare expenditures. MCO cost-control tactics create ethical problems regarding patient care, provider-patient relationships, access to services, and equal treatment (Bates et al., 2014). This article examines MCO cost management strategies' ethical benefits and disadvantages from the perspective of healthcare ethics.
Strategies Employed by Managed Care Organizations for Cost Control
As I have discussed, MCOs control healthcare expenses through various ethical strategies. Firstly, Utilization Management monitors and controls medical service consumption to ensure medical necessity (Ginter et al., 2018). This action may reduce overutilization but raises questions about denying essential treatments and interventions and balancing budgetary responsibility and patient welfare. Secondly, Drug Coverage and Pharmaceutical Control are formularies encouraging patients toward cost-effective drugs, reducing costs but raising ethical concerns about restricting treatment options.
Benefits and Disadvantages of Cost Control Measures
Benefits
The following are the benefits of cost control measures.
Affordability and Accessibility
Managed care companies may lower healthcare costs for more people by controlling costs. Efficient healthcare cost management reduces patient and family financial stress, thus increasing affordability that makes essential medical treatments more accessible to more people, regardless of income, improving well-being. This method ensures that healthcare is not disproportionately available to the wealthy (Shahid et al., 2019).
Preventing Overutilization
Utilization management and pre-authorization rules avoid needless medical operations where overutilization is reduced by aligning medical services with medical needs and care standards. This benefit prevents unneeded medical procedures, which saves money and protects people, eliminating superfluous operations and minimizing healthcare costs, freeing up resources for more urgent patients.
Disadvantages
Cost of control measures have the following disadvantages.
Quality of Care
Cost management is crucial, but overdoing it might harm care quality. Essential treatments or interventions may be withheld or curtailed owing to cost, violating beneficence and requiring healthcare provid...