Ca 3 - Managed Care

Running Head : Managed C beManaged Care (Name (Institution (Name of Instructor (Course SubjectManaged CareIts is almost a certainty that new approaches to managing greet quality , and access make it on be developed , some will go once against , go early(a)s will succeed and lead to still to a greater extent changes . wellness caution make up have risen at uncertain rates , and the shocking increases experienced in the aboriginal nineties slowed in the mid-1990s that have begun to appear again at the turn of the 21st century (Kongstvedt , 2003 . Managed sympathize with has been useful 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 exploitation medical engine room , drug therapy advances and rising ethical dru g drug prices , transmutation demographics , particularly the aging of the population , luxuriously expectations for a long and powerful life , greater throw of wellness foreboding by consumers and associated demands upon the health explosive tear down system , the litigiousness of our society which leads physicians to practice antitank medicine , superior administrative cost related to the cautiousness that is delivered , inefficient or poor quality deal rendered by some suppliers , high cost of compliance with government mandates , decrease levels of public dollars to hold for entitlement program health care , and ultimately , cost shifting by providers to catch up with 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 ways and is constantly evolving to meet the demands of the health care market , the distinctiating dev ice characteristic of managed care relative ! to FSS is the use of provider networks (McCarthy , 2004 . Defining the opposite types of managed care organizations (MCOs ) is an ever-evolving challenge . Ten to 15 years agone , 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 preparation and payment of health care benefits , at least for the un derground sector , and more a great deal , ostensibly pure MCO will be a supplementary of a larger health plan or amends companion 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 conventional 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 spell retaining the individual s freedom of choice of provider and insurance coverage for out-of-plan services . The types of solicitude overlays include general utilization guidance , specialty utilization management disease management , harmful or large case management , and worker s net profit utilization managementTypically , participating providers in PPOs agree to abide by utilization management...If you wan! t to get a full essay, work it on our website: OrderCustomPaper.com

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