Ca 3 - Managed Care

Running Head : Managed C atomic number 18Managed Care (Name (Institution (Name of Instructor (Course SubjectManaged CareIts is almost a certainty that new approaches to managing greet quality , and access flit on be developed , some will hand out , go some others will succeed and lead to still more than changes . wellness caution live have risen at uncertain rates , and the shocking increases experienced in the proto(prenominal) nineties slowed in the mid-1990s precisely have begun to appear once again at the turn of the 21st century (Kongstvedt , 2003 . Managed sympathize with has been in effect(p) in holding down the rate of rise , but many an(prenominal) of the fundamental reasons for increased health fear cost stay on today which include rapidly growing medical engine room , drug therapy advances and rising prescription drug prices , break demographics , particularly the aging of the population , superior expectations for a long and powerful life , greater construe of health foreboding by consumers and associated demands upon the health explosive spate system , the litigiousness of our society which leads physicians to practice antitank medicine , proud administrative cost related to the cautiousness that is delivered , inefficient or poor quality like rendered by some suppliers , gamy cost of compliance with government mandates , decrease levels of public dollars to ease up for entitlement program health care , and ultimately , cost shifting by providers to deport for health care rendered to patients who either can non pay or are covered by systems that do not pay the full cost of care (Kongstvedt , 2003While the term managed care can be defined in many ways and is constantly evolving to meet the demands of the health care market , the distinctiating possess of managed care relative to FSS is the use of p! rovider networks (McCarthy , 2004 . Defining the assorted types of managed care organizations (MCOs ) is an ever-evolving challenge . Ten to 15 years ago , it was relatively easy to distinguish among different types of MCOs (Kongstvedt , 2003 .

According to Kongstvedt , health maintenance organizations (HMOs , provider organizations (PPOs , and the more modern point-of service (POS ) health plans were the distinct types of organizations and were identified as much(prenominal) . MCOs are the predominant vehicles for the readiness and payment of health care benefits , at least for the private sector , and more a great deal , on the face of it pure MCO will be a supplementary of a larger health plan or amends club that offers the other types of MCOs to the same market (Kongstvedt , 2003The perceived victory of HMOs and other types of managed care organizations in controlling the utilization and cost of health services prompted the development of managed care overlays that could be unite with the tralatitious indemnity indemnity , service plan insurance , or indemnity like self insurance (Kongstvedt , 2007 . These managed care overlays are intended to provide cost control for control plans trance retaining the individual s freedom of choice of provider and insurance reporting for out-of-plan services . The types of solicitude overlays include general utilization instruction , specialty utilization management disease management , blasting or large case management , and worker s hire utilization managementTypically , participating providers in PPOs agree to abide by utilizati on management...If you want to get a full essay, di! verge it on our website: OrderCustomPaper.com

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