Final answer:
Controlling costs in case management should not be the primary goal when a child's well-being is involved. Health maintenance organizations (HMOs) attempt to manage patient care and costs efficiently but must balance these with quality of life and care necessities. Adverse selection and resource allocation within healthcare policies are also critical factors to consider.
Step-by-step explanation:
When a case manager is assigned to coordinate the care of a child with a complex medical condition, controlling costs is indeed a real-world concern. However, this should not be the primary goal, especially when dealing with sensitive and complex cases where a child's well-being is at stake. Cost control can lead to significant barriers to success, particularly if it results in the rationing of necessary health care services or impedes access to comprehensive care.
Health care systems like health maintenance organizations (HMOs) are structured to manage costs effectively while still providing care. They receive reimbursement on a per capita or per-visit basis, rather than for individual services, which incentivizes providers to focus on overall patient health and cost efficiencies. Despite this, the primary objective of case management should always be the health and quality of life of the patient, with cost control as a secondary objective that should be balanced against the necessary care for the child.
Further, the problems of adverse selection and allocation of resources must be taken into account when developing policies that involve both cost control and patient care. Adverse selection can occur if insurance plans do not balance the needs and costs effectively, leading to higher costs for high-risk parties and exclusion of low-risk parties.