To the insurance industry, quality care became defined as being able to choose your own doctor. But that, it seems to me, isn't nearly the image that comes to mind for quality care. Quality care means making sure you've got adequate numbers of nurses, adequate numbers of other support personnel that go into making a good hospital or facility. As a result, hospitals are scrambling to reduce costs so that they can bid a lower price and win more managed care contracts. In another drive to lower costs, hospitals also limit the length of patient stays.
Lower census means lower revenues, an incentive for hospital administrators to lower costs.
Many hospitals have started opening administrative and medical departments on weekends in an effort to discharge people sooner. As a result, there is pressure on doctors to limit hospitalizations or discharge patients too quickly. Another major trend stemming from managed care combined with advances in medical technology is the fact that more and more care is being provided in outpatient settings. Proponents of managed care say that preventive care leads to improved medical outcomes and fewer hospitalizations, reduced length of stays and charges.