Ca 3 - Managed Care

Running Head : Managed C areManaged Care (Name (Institution (Name of Instructor (Course SubjectManaged CareIts is almost a certainty that new approaches to managing greet quality , and access take to the woods on be developed , some will depart , go separates will succeed and lead to still more changes . wellness caution woo have risen at uncertain rates , and the shocking increases experienced in the proto(prenominal) nineties slowed in the mid-1990s nonwithstanding have begun to appear once again at the turn of the 21st century (Kongstvedt , 2003 . Managed sympathize with has been impelling in holding down the rate of rise , but many an(prenominal) of the fundamental reasons for increased wellness fear cost stay on today which include rapidly growth medical engine room , drug therapy advances and rising prescr iption drug drug prices , break demographics , particularly the aging of the population , tall expectations for a long and powerful life , greater engage of health foreboding by consumers and associated demands upon the health explosive rushing system , the litigiousness of our society which leads physicians to practice antitank medicine , highschool-pitched administrative cost related to the cautiousness that is delivered , inefficient or poor quality fretting rendered by some suppliers , high cost of compliance with government mandates , decrease levels of public dollars to profits for entitlement program health care , and ultimately , cost shifting by providers to move over for health care rendered to patients who either cannot 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 slipway and is constantly evolving to meet the demands of the health care market , the distinctiat ing cause of managed care relative to FSS i! s the use of provider networks (McCarthy , 2004 . Defining the contrastive types of managed care organizations (MCOs ) is an ever-evolving challenge . Ten to 15 years past , 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 furnish and payment of health care benefits , at least for the semiprivat e sector , and more a great deal , plainly pure MCO will be a supplementary of a larger health plan or amends caller 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 handed-down 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 bit 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 focus , specialty utilization management disease management , ruinous or large case management , and worker s requital utilization managementTypically , participating providers in PPOs agree to abide by uti lization management...If you want to get a full essay! , figure out it on our website: OrderCustomPaper.com

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