Managed Care: The Pros And Cons Of Managed Care

209 Words1 Page
bulb-icon

Recommended: managed care disadvantages

In the past when there were no managed care plans the beneficiaries would be allowed to go to any doctors, now because of managed care they have one primary doctor who manages their care and refer them to other types of doctors if necessary. Managed care has its pros and cons, in one way it is good to have one doctor taking care of you all the time but at the same time it is very restricting when you either want or must go outside of your network. In my opinion, I do not care for managed care because of an experience I had over 20 years ago. My daughter was a child and had an asthma attack, the ambulance took me to a nearby hospital but when I called to alert my managed care on her condition, they told me I had to go to another hospital that

Show More
Related

  • Patient Protection and Affordable Care Act: Pros and Cons

    1398 Words  | 3 Pages

    One of the most controversial topics in the United States in recent years has been the route which should be undertaken in overhauling the healthcare system for the millions of Americans who are currently uninsured. It is important to note that the goal of the Affordable Care Act is to make healthcare affordable; it provides low-cost, government-subsidized insurance options through the State Health Insurance Marketplace (Amadeo 1). Our current president, Barack Obama, made it one of his goals to bring healthcare to all Americans through the Patient Protection and Affordable Care Act of 2010. This plan, which has been termed “Obamacare”, has come under scrutiny from many Americans, but has also received a large amount of support in turn for a variety of reasons. Some of these reasons include a decrease in insurance discrimination on the basis of health or gender and affordable healthcare coverage for the millions of uninsured. The opposition to this act has cited increased costs and debt accumulation, a reduction in employer healthcare coverage options, as well as a penalization of those already using private healthcare insurance.

    Read More

  • Network Development In The Managed Care Organization

    1375 Words  | 3 Pages

    To guarantee that its members receive appropriate, high level quality care in a cost-effective manner, each managed care organization (MCO) tailors its networks according to the characteristics of the providers, consumers, and competitors in a specific market. Other considerations for creating the network are the managed care organization's own goals for quality, accessibility, cost savings, and member satisfaction. Strategic planning for networks is a continuing process. In addition to an initial evaluation of its markets and goals, the managed care organization must periodically reevaluate its target markets and objectives. After reviewing the markets, then the organization must modify its network strategies accordingly to remain competitive in the rapidly changing healthcare industry. Coventry Health Care, Inc and its affiliated companies recognize the importance of developing and managing an adequate network of qualified providers to serve the need of customers and enrolled members (Coventry Health Care Intranet, Creasy and Spath, http://cvtynet/ ). "A central goal of managed care is containing the costs of delivering care, but the wide variety of organizations typically lumped together under the umbrella of managed care pursue this goal using combination of numerous strategies that vary from market to market and from organization to organization" (Baker , 2000, p.2).

    Read More

  • Managed Care: An Overview and Its Uncertain Future

    1114 Words  | 3 Pages

    What is managed care? According to the Oxford English Dictionary, managed care is “a system of health care in which patients agree to visit only certain doctors and hospitals, and in which the cost of treatment is monitored by a managing company.” Managed care is a variety of techniques designed to reduce the cost of providing health benefits and advance the quality of care. In the United States alone, there are various managed care programs, that are ranged from more restrictive to less restrictive. As stated in the National Institutes of Health, the future of managed care is uncertain. It is enthralling to note that in spite of the advances in healthcare systems, such as our hospital’s ability to provide patients with lower cost, managed

    Read More

  • The Pros and Cons of Obamacare

    1705 Words  | 4 Pages

    The topic that I am choosing to do is on Obama Care. I chose this topic because the idea of the government forcing people to obtain insurance is wrong in my eyes. I am interested in analyzing the validity for what has been said about this topic in order to increase my understanding about Obama Care. I am not an expert when it comes to Obama Care. I know that this is an insurance that is being provided through the government for the general public. I have read that President Obama never initially read the whole bill itself. I also know that people who cannot afford it, but make too much money to qualify for Medicaid are being heavily encouraged to get this insurance. Some of the common knowledge that I have found that the general public has about this subject is that some people are for Obama Care and think that it is a wonderful idea and that there are some people that are dead set against Obama Care. Younger adults, specifically college age and individuals that are in their twenties tend to be for Obama Care. The insurance is being forced upon individuals that may or may not want it. It also seems as though that the insurance being offered is pretty generic in terms of coverage. Some of the questions that I have that I believe will aide me in writing this paper would be the following: What are the pros and cons of Obama Care? What are the thoughts of Obama Care with the people of the government? As well as what are the basics of Obama Care?

    Read More

  • Pros and Cons of the Patient Protection and Affordable Care Act

    518 Words  | 2 Pages

    Just mention the word "Obamacare" and a heated debate will start right away. The legal name of Obamacare is "the Patient Protection and Affordable Care Act, PPACA" (Tate 1). The law has over 2500 pages and many have not read the entire law (Tate 12). Democrat Nancy Pelosi made an infamous remark back in 2010 stating "that Congress '[has] to pass the bill so you can find out what's in it'"...(Roff). This law was signed in March of 2010 and has a 54% disapproval rating among Americans today (Amadeo). The main goals of the law are to offer healthcare to all Americans, stop the rising costs of insurance, increase the number of "consumer benefits and protection", and solve several other healthcare concerns (Tate 13-15). What are some of the pros and cons of PPACA, and is this law good or bad for our country at this time?

    Read More

  • The Pros And Cons Of The Affordable Care Act

    1303 Words  | 3 Pages

    The individual mandate and the Affordable Care Act, also known as “Obamacare”, is the idea that citizens should be required to have health insurance or otherwise pay a certain penalty. The Affordable Care Act essentially is the ability for all Americans to be able to afford health insurance. “One goal of the ACA, often referred to as the Affordable Care Act…is to bring down the costs of health care and make it available to more people.” (Will the Affordable Care Act improve health care in the United States?). The ACA was signed into law in March 2010 and currently ongoing. Although the Affordable Care Act does potentially have some positive effects to it, like bringing affordable health insurance to uninsured Americans; the Act does also have

    Read More

  • Managed Health Care Issues

    3218 Words  | 7 Pages

    When one examines managed health care and the hospitals that provide the care, a degree of variation is found in the treatment and care of their patients. This variation can be between hospitals or even between physicians within a health care network. For managed care companies the variation may be beneficial. This may provide them with opportunities to save money when it comes to paying for their policy holder’s care, however this large variation may also be detrimental to the insurance company. This would fall into the category of management of utilization, if hospitals and managed care organizations can control treatment utilization, they can control premium costs for both themselves and their customers (Rodwin 1996). If health care organizations can implement prevention as a way to warrant good health with their consumers, insurance companies can also illuminate unnecessary health care. These are just a few examples of how the health care industry can help benefit their patients, but that does not mean every issue involving physician over utilization or quality of care is erased because there is a management mechanism set in place.

    Read More

  • HMO Regulation

    1302 Words  | 3 Pages

    Health Maintenance Organizations, or HMO’s, are a very important part of the American health care system. Also referred to as managed care programs, HMO's are combinations of doctors and insurance companies that are formed into one organization. This organization provides treatment to its members at fixed costs and decides on what treatment, if any, will be given based on the patient's or doctor's current health plan. Sometimes, no treatment is given at all. HMO's main concerns are to control costs and supposedly provide the best possible treatment to their patients. But it seems to the naked eye that instead their main goal is to get more people enrolled so that they can maintain or raise current premiums paid by consumers using their service. For HMO's, profit comes first- not patients' lives.

    Read More

  • TRICARE Standards

    268 Words  | 1 Pages

    Beneficiaries who are satisfied with the treatment they receive from a particular provider that may not be in the TRICARE provider network often choose to use TRICARE Standard. Retirees under 65 and their families, may live in ranges where the

    Read More

  • Understanding the Downfalls of the Affordable Care Act

    1527 Words  | 4 Pages

    Just a few years ago the Affordable Care Act otherwise known as the ACA. The Affordable Care Act is also famously know as Obamacare. This has not been very good for the American people in several ways. It has caused the people of this great nation a very difficult time in signing up for this new healthcare, everyone’s insurance prices have risen, people have been losing a lot of hours at work, and if people decide not to have insurance they can be fined. The way to get rid of all of these problems is to get rid of the Affordable Care Act all together.

    Read More

  • The Pros And Cons Of Health Care

    639 Words  | 2 Pages

    Luckily under the new health care reform law, most people will receive help paying for their healthcare premiums and cost-sharing expenses that people with insurance have to pay out of pocket for doctor visits, and prescription medicine. Families and individuals will be able to receive this assistance with incomes between one hundred and four hundred percent of the federal poverty line. One hundred to four hundred percent makes up at about $23,000 to $94,000 a year assume this is for a family of four.

    Read More

  • Managed Care

    928 Words  | 2 Pages

    In conclusion, managed care integrates the functions of financing, insurance, delivery, and payment within an organization. It also exercises formal control over utilization. Managed care is viewed as accepting the lowest competitive bid for services rendered. Today, HMOs and PPOs are the most common and widely used models for managed care. Although managed care is here to stay, it requires revision in some areas. Challenges that are to be faced include double agentry, fidelity, confidentiality, honesty, and vulnerability. With the help and guidance of health information professionals, managed care will continue to escalade and become better for all.

    Read More

  • Rethinking the U.S. Health Care System: A Call for Efficiency

    1854 Words  | 4 Pages

    While most countries around the world have some form of universal national health care system, the United States, one of the wealthiest countries in the world, does not. There are much more benefits to the U.S. adopting a dorm of national health care system than to keep its current system, which has proved to be unnecessarily expensive, complicated, and overall inefficient.

    Read More

  • Pros And Cons Of Health Insurance

    745 Words  | 2 Pages

    Ans 1) To mandate the insurance or not is a big question to be answered and still there are a lot of problems associated with mandating the Health Insurance in United States. A lot of views have been given by people regarding whether there is need of mandating the Health Insurance or not.

    Read More

  • Reflection Paper On Health Insurance

    701 Words  | 2 Pages

    Managed health care actually combines health care delivery with the financing of services provided. This was intended to replace conventional fee-for service plans with much more affordable quality of care to the health consumers as well as the providers who was in agreement with the restrictions. However, managed care is becoming challenged due to the growth of consumer-directed health plans, which defines employer continuations and asking employees to be more responsible within their health care decisions and cost-sharing. The Americans health care system has been changing the way their health care services are organized and delivered. As seen by the movement from traditional fee-for-service systems to managed care networks. Ranging from structured staff model HMOs to the lesser structured preferred provider organizations (PPO). Statistics show that 60 million Americans are enrolled with some type of managed care program within the response to regulatory initiatives which affect health care cost and quality. Managed care organizations are responsible for the health of their enrollees, which can be administered by a physician’s group, health system, or even a hospital. Much of the managed care financing is through a method called capitation, and the enrollees are assigned to a select primary care provider, which serves as a gatekeeper.

    Read More

More about Managed Care: The Pros And Cons Of Managed Care

Open Document