Preview

Types Of Managed Care

Satisfactory Essays
Open Document
Open Document
133 Words
Grammar
Grammar
Plagiarism
Plagiarism
Writing
Writing
Score
Score
Types Of Managed Care
Managed care plans are a type of healthcare insurance that have contracts with healthcare providers and other medical facilities where they can provide medical services at a lower price. Depending on the networks rules determines how much care your plan will pay for.

"Plans that restrict your choices usually cost you less." ("Managed Care: MedlinePlus," n.d.)

There are three types of managed care plans which are health maintenance organizations (HMO), preferred provider organizations (PPO), and point of service (POS). A main goal behind the creation of manged care plans is to provide healthcare with emphasis on prevention. Managed care plans are more affordable for the patients because by helping them get care sooner than later, providers

You May Also Find These Documents Helpful

  • Good Essays

    Hcr 230 Week 1 Assignment

    • 473 Words
    • 2 Pages

    There are nine private payer plans which include preferred provider organizations (PPO), health maintenance organizations (HMO), point of service (POS). Indemnity plans cost the most for employees and they usually have to choose a PPO plan. The new consumer driven health plan (CDHP) which a lot of people are picking, it has a high deductible combined with a funding option of some type. All of the plans have unique features for coverage of services and financial responsibility.…

    • 473 Words
    • 2 Pages
    Good Essays
  • Satisfactory Essays

    The "Preferred Provider Organization" or PPO is the most popular types of plan that individual and families get for insurances. With this plan you can visit any in-network physician and/or healthcare’s providers without requiring a referral from a primary care physician. PPO is all about reducing the cost of care and claims processing, so therefore reducing the premium you to have to pay to the health insurance. The PPO can also be called” claims network”. PPO may not have copayment for doctor’s visit and prescription, and may not be for going to specific doctors and hospitals. PPO helps file out claims properly. PPO arrangement prevents, manager and/or operator approaches medical providers. Manager of the PPO fixed payments, make a contract,…

    • 217 Words
    • 1 Page
    Satisfactory Essays
  • Good Essays

    Preferred provider organizations (PPOs) are a private plan which is the most popular, followed by health maintenance organizations (HMOs). PPOs sometimes pay participating providers based on a discount from their physician fee schedules which is called a discounted fee-for-service. With a PPO the patient pays annual premiums and often a deductible. The patient has two choices with the first being offered a low deductible with a higher premium and the second being a high deductible with a low premium and they always pay a copayment at the time medical services are rendered. Consumer-driven health plans (CDHPs) combine two components with the first being a high-deductible…

    • 738 Words
    • 3 Pages
    Good Essays
  • Powerful Essays

    Preferred provider organizations (PPOs) are based on membership to a specific health care provisions arrangement. As part of the PPO, the provider participates in this arrangement providing patients with services guided by discounted fee-for-service. This type of service is at a discount from their normal physician fee schedules. Other features of this plan include either a lower premium and higher deductible or visa versa. Copayments are also included in this plan and there could be an annual out-of-pocket deductible. Patients also have the choice of their providers although out-of-network providers will cost more on the patient’s part than provider’s in-network. One thing to remember though is that all non-emergency services require pre-authorization (Valerius, J., Bayes, N., Newby, C., & Seggern, J. (2008). According to WiseGEEK.com, “Most PPOs have a preferred provider list, much like the HMO provider list. Usually, seeing someone on the list means less expense. In fact, the PPO basically has an HMO component and network built into it” (para.6).…

    • 1649 Words
    • 7 Pages
    Powerful Essays
  • Satisfactory Essays

    Health Maintenance Organizations or HMOs only allow people to see providers that are within the HMO system. The primary care physician has to make all referrals and manages all the care. There are no payments for out of plan non-emergency services but some care requires pre-authorizations. This plan features low copayments, there is a limited provider organization and pre-caution care is covered with this plan.…

    • 373 Words
    • 1 Page
    Satisfactory Essays
  • Satisfactory Essays

    Managed Care Case Study

    • 167 Words
    • 1 Page

    Managed care contributes a vast amount to the healthcare system. Without managed care systems I don’t think health facility, insurances agencies and companies would manage. Agree, professionals are to adapt and accommodate changes based on contracts between managed care systems and other agencies. In my opinion, the technology advancement within the health care system has improved tremendously in a positive way. For example; when I switched my daughter primary doctor around shot time, me being old fashion handed her the paper shot record. She replied “ma’am it already imported into the system; we don’t use the paper anymore.” This is totally a successful and less stressful outcome on a person if it was to get lost or misplaced. These…

    • 167 Words
    • 1 Page
    Satisfactory Essays
  • Satisfactory Essays

    Features of Heaalth Plans

    • 337 Words
    • 2 Pages

    A HMO is like a club for both patients and providers. Subscribers to an HMO receive medical services from participating physicians, clinics and hospitals. PPOs offer choices and access, but there is typically a cost associated with that freedom which is quite higher than HMO costs. Point-Of-Service, these plans combine characteristics of HMOs and PPOs. You choose a primary care physician who controls all aspects of care, including referrals to specialists, all care received under that physicians guidance is fully covered. Traditional Indemnity is the least restrictive option of the three main plan types. IT lets you see any licensed health care professionals for anything covered by the insurance, you choose the deductible and other options when you…

    • 337 Words
    • 2 Pages
    Satisfactory Essays
  • Satisfactory Essays

    There are many reasons why the managed care delivery model was created mostly to reduce cost and to remove unnecessary testing and treatment. I am going to Describe two different types of managed care, and the differences between the two.…

    • 173 Words
    • 1 Page
    Satisfactory Essays
  • Satisfactory Essays

    Some of the similarities between the major health care options between the HMO organization and the POS organization are that both of these organizations require that a primary care physician manages the care. They also have lower copayments and cover preventive care. The HMO, Indemnity Plan and the PPO require preauthorization on procedures while all five…

    • 269 Words
    • 2 Pages
    Satisfactory Essays
  • Satisfactory Essays

    Difference and Plan

    • 345 Words
    • 2 Pages

    These health plans have a lot of similarities and differences. Some of the similarities are the majority of these plans have low copayments, and very close coverage. The HMO and POS plans have lower copayments than some of the other plans and these plans cover the total cost of preventative care. Some of the plans allow you to go out of network and the other plans will not pay or cover unless it is in the network.…

    • 345 Words
    • 2 Pages
    Satisfactory Essays
  • Good Essays

    The three major type of manage car plans include Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Point of Service (POS). HMOs are a prepaid basis provider, where there members pay a fixed monthly fee, regardless of the medical care needed monthly. The medical service provided by an HMO can vary for office visit to hospitalization or surgery. Member can only receive medical treatment from the in-network physicians or facilities. HMO member can only be referred by an in-network physician to a specialist. Choosing an HMO provide a significant out of pocket savings to their members when see in-network physicians (Senterfitt, 2005).…

    • 686 Words
    • 3 Pages
    Good Essays
  • Better Essays

    Evolution of Managed Care

    • 1519 Words
    • 7 Pages

    Managed care is a type of system that was formed to help control the costs and quality to health care services; this will give access to services to specific groups of covered patients. The system was created to help the patients (customers) to receive services without having the full financial burden (University of Washington, 1998). The managed care services’ goal is to be able to help individuals and their families by providing health care services that is affordable. This type of managed care will help employees or individuals by requiring a set fee to be paid to the physician for visits, a co-pay and monthly premium to be paid to the insurance company. This will lower the amount that the patient has to pay. There have been many demands that have been needed in the managed care system; changes have had to be made to keep improving the health care services to help it to continue to grow. This paper will cover how the managed care began, in addition to how the system has grown and the changes of the system.…

    • 1519 Words
    • 7 Pages
    Better Essays
  • Powerful Essays

    Managed Care

    • 4818 Words
    • 20 Pages

    At the Intersection of Health, Health Care and Policy Cite this article as: E Friedman Managed care, rationing, and quality: a tangled relationship Health Affairs, 16, no.3 (1997):174-182 doi: 10.1377/hlthaff.16.3.174…

    • 4818 Words
    • 20 Pages
    Powerful Essays
  • Better Essays

    Managed Care

    • 1408 Words
    • 6 Pages

    HealthPocket; analysis: 80 percent of health plans charge higher premiums than they first quote to consumers. (2013). Managed Care Business Week, , 5. Retrieved from http://search.proquest.com/docview/1313166853?accountid=32521…

    • 1408 Words
    • 6 Pages
    Better Essays
  • Better Essays

    Managed Care

    • 3374 Words
    • 14 Pages

    Managed care is the most common form of health insurance in the United States, and provides…

    • 3374 Words
    • 14 Pages
    Better Essays