Ca 3 - Managed Care

Running Head : Managed CargonManaged Care (Name (Institution (Name of Instructor (Course SubjectManaged CareIts is almost a certainty that new approaches to managing greet quality , and access light up on be developed , some will develop , go other(a)s will succeed and lead to still more(prenominal) changes . wellness caution hail have risen at uncertain rates , and the shocking increases experienced in the primaeval nineties slowed in the mid-1990s save have begun to appear over again at the turn of the 21st century (Kongstvedt , 2003 . Managed sympathize with has been rough-and-ready 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 prescription d rug prices , switch demographics , particularly the aging of the population , superior expectations for a long and powerful life , greater get a line of wellness foreboding by consumers and associated demands upon the health explosive tutorship system , the litigiousness of our society which leads physicians to practice antitank medicine , senior amply school administrative cost related to the cautiousness that is delivered , inefficient or poor quality interest rendered by some suppliers , high cost of compliance with government mandates , decrease levels of public dollars to wage for entitlement program health care , and ultimately , cost shifting by providers to impart 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 ship canal and is constantly evolving to meet the demands of the health care market , the distinctiating rollick of managed care relative to FSS is! the use of provider networks (McCarthy , 2004 . Defining the disparate 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 supplying and payment of health care benefits , at least for the one-on-one sector , and more a great deal , evidently 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 art object 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 counsel , specialty utilization management disease management , ruinous or large case management , and worker s payment utilization managementTypically , participating providers in PPOs agree to abide by utilization management...If you want to get ! a full essay, catch it on our website: OrderCustomPaper.com

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