Managed Care plans

Jeff Harvey 4/16/08 Bus 443 One of the biggest concerns today for gracious resources professionals is controlling health cargon costs. When deciding upon health benefits in that respect are several different options to choose from. Growing in popularity of the past several years are Managed Care Plans. The office of managed care, as it sounds, is to manage costs. It does this by limiting the doctors and hospitals program participants are able to visit if they wish to receive coverage. Managed Care Plans by and large come in three common forms; Health sustenance Organization (HMO), Preferred Provider Organization (PPO), and Point-of-Service (POS). The main topics to deal when talking about Managed Care Plans include the administrative requirements, profound requirements, and the various reporting and disclosure issues. The Health Maintenance Organization, or HMO, is the most popular form of managed care organization in spite of appearance the U.S employee group market, although many other structures and hybrid structures are available. under(a) HMOs the employer will pay capitation fee, usually annually, that covers plan participants for medical expenses. The annual fee is paid prior to the tangible health care serve. Plans very on what medical services are in full covered and what arent.

If the service isnt fully covered the participant is required to pay a co-payment (also varies). 1 Plan participants are required to see a primary quill care physician (PCP) as a means to inspection and repair control costs by reducing the number of needless visits to specialists. Several different roles of PCPs include: canvass and Evaluating a patients condition Identifying preaching options Deciding whether treatment is needed Evaluating the patient after the treatment2 HMOs can be differentiated into four common types. A staff determine HMO exists when the HMO owns the facilities and employs the medical staff to work on the premises. Physicians treat only members of the HMO and are compensated on a salary... If you want to get a full essay, coif it on our website: Orderessay

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