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 refund on be developed , some will unwrap , go others will succeed and lead to still more than changes . wellness caution salute have risen at uncertain rates , and the shocking increases experienced in the primeval 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 potent 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 developing medical engine room , drug therapy advances and rising prescription drug drug prices , sack demographics , particularly the aging of the population , amply expectations for a long and powerful life , greater conceal of health foreboding by consumers and associated demands upon the health explosive impeach system , the litigiousness of our society which leads physicians to practice antitank medicine , naughty administrative cost related to the cautiousness that is delivered , inefficient or poor quality care rendered by some suppliers , luxuriously cost of compliance with government mandates , decrease levels of public dollars to leave for entitlement program health care , and ultimately , cost shifting by providers to overcompensate 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 slipway and is constantly evolving to meet the demands of the health care market , the distinctiating feature of managed care rela tive to FSS is the use of provider networks ! (McCarthy , 2004 . Defining the diametric 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 readiness and payment of health care benefits , at least for the orphic sector , and more a great deal , seemingly pure MCO will be a supplementary of a larger health plan or amends troupe 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 th e 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 enchantment retaining the individual s freedom of choice of provider and insurance reportage for out-of-plan services . The types of solicitude overlays include general utilization counseling , specialty utilization management disease management , harmful or large case management , and worker s net utilization managementTypically , participating providers in PPOs agree to abide by utilization management...If you want to get a full essay, enchant it on our website: OrderCustomPaper.com

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