Managed Care Delivery Model Analysis
The managed care delivery model was intended to decrease unneeded health care costs, by controlling the level of service along with the type of service that was being provided. This model came in a response to the rocket costs of the unrestricted fee-for-service plans in the 1980s. (PBS.org) Managed care plans are a type of health insurance. There are several ways the managed care model is expressed one particular way is the Health Maintenance Organization or better known as HMO. HMOs have their own network of doctors, hospitals and other health care providers who have agreed to accept a payment plan at a certain level of services they provide. With HMO, you would have to pick a Primary Care Physician within the local approved network where that doctor can coordinate any additional care you might need. If you need a specialist, a referral would be needed within the HMO network. HMOs usually have lower monthly premiums, but out of network health care professionals are not typically covered by the insurance.
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This is similar to the HMO, it offers a network of doctors, hospitals and other health care providers at a certain rate. The PPO plan gives more flexibility on health care needs. You do not need a Primary Care Physician, and you can go to any specialist without a referral. You can go to any health care professional in or out of network. If you stay in your network you will have smaller copays,and will be fully covered. If you go outside your network you will have higher out-of-pocket costs and run the chance of not being fully covered. PPOs are going to have higher monthly premiums and there will be an annual deductible that has to be
This is similar to the HMO, it offers a network of doctors, hospitals and other health care providers at a certain rate. The PPO plan gives more flexibility on health care needs. You do not need a Primary Care Physician, and you can go to any specialist without a referral. You can go to any health care professional in or out of network. If you stay in your network you will have smaller copays,and will be fully covered. If you go outside your network you will have higher out-of-pocket costs and run the chance of not being fully covered. PPOs are going to have higher monthly premiums and there will be an annual deductible that has to be