Managed Health Care Essay - 1029 Words

Managed Health Care Managed health care is a system used to control costs, quality of and access to health care services, as well as the delivery of health care services to it’s members. Managed health care started in the 1980’s in response to rising health care costs and new, advancing technology and equipment, which costs more to operate. Members can enroll in one of these three types of health care plans. Health Maintenance Organization (HMO) is one in which doctors, hospitals, and other health care professionals together form a provider network. They provide services at a discounted rate in exchange for receiving health plan referrals. Then an individual would select a Primary Care Physician (PCP) from a list of approved PCP’s.†¦show more content†¦Some people may feel that managed care is violating their right to choose this isn’t completely true. If you want more freedom in choice then you can pick a PPO or POS. If not, then a HMO is the one you could choose. Y ou have to find what best fits your needs, but also be prepared to pay more in co-payments and deductibles if you select a more flexible plan. The Health Insurance Portability and Accountability Act or more commonly known as HIPAA was made into a federal law in 1996 and came about to serve multiple tasks, to improve efficiency of health care by reducing costs, lift administrative burdens on health care and to better protect the privacy of patients personal health care information. Medical Assistants are the ones that work with patients the most and need to take great caution to make sure they follow HIPAA guidelines and the proper procedures. While also making sure the office and their selves are protecting the privacy and confidentiality of their patients information. HIPAA was designed to minimize disruptions in patient care and there are no regulations on exchanging information to fulfill treatment. Providers can also continue to exchange patient information related to referrals and consultations. It also requires providers to inform their patients of their rights through a notice of privacy practices statement. According to HIPAA if you are in violation of anyShow MoreRelatedManaged Care Through The Delivery Of Health Care854 Words   |  4 PagesManaged care integrates the delivery of health care and financing of health care. In managed care, insurance companies controls the cost, quality, and access of medical care to beneficiaries by limiting the reimbursement levels paid to providers,, by reducing utilization, or both (Beik, 2014, p. 116). There are different types of managed care. Some of the most common types of managed care are Preferred Provider Organization (PPO) and Health Maintenance Organizations. Managed care programs uses differentRead MoreManaged Care : A Complex Health Care System1469 Words   |  6 PagesManaged Care is a complex health care system in which physicians, hospitals, and other healthcare professionals organize in an interrel ated system of people and facilities that communicate with one another and work together as a unit, commonly referred to as a network. This network coordinates and arranges health care services and benefits for a specific group of individuals, referred as enrollees, for the purpose of managing costs, quality, and access to health care. The Managed care program mayRead MoreThe Managed Health Care System1678 Words   |  7 PagesIntroduction The managed health care system is a complex process that must align financial incentives and goals. Therefore, managed care is thought of as a complex puzzle that once one piece is moved it will affect the outcomes of the rest of the system (Boyd Finamn, 2010). As a result, it is essential that the managed care organization have the ability to align its financial incentives with the goals of all parties involved, such as the providers who deliver healthcare services and the health insuranceRead MoreManaged Health Care Analyzed Essay1837 Words   |  8 PagesThe health care industry in the United States is very diverse and dynamic. The continued growth of managed health care is influenced by the economy, the need, and the regulatory regulations set forth on the industry. If one of these forces changes, it can affect the entire group; this causes the managed health care industry to be at the mercy of its roots and the industry’s need for it. What started out as a simple idea has turned into a complex and ever growing industry that is necessary for theRead More Managed Health Care Issues Essay3222 Words   |  13 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 insuranceRead MoreHistory Of Managed Care And Health Maintenance Organizations1034 Words   |  5 Pagesin the Military a very familiar with managed care, we may not totally understand the concept of managed cared but are recipients of it daily. Unless there is a heated political debate about health care reform we usually don’t worry about health care reform. Health care cost is not something that we worry about; after all the government takes care of all our medical needs, even when we are seen out on the economy. The only time we might the troubles of health cost might visit our door steps occurRead MoreThe Organizational Theory That Drives The Managed Health Care805 Words   |  4 PagesDamaged Care Health care organizations are complex entities whose theory and structure have evolved and transitioned over time. In the late 1980s and early 1990s health care experienced a paradigm shift as managed care organizations guided health care practices by managing the care between patients and physicians in order to drive down health care costs. This transition has created controversy and discontent as physicians, patients and payers balance what is required to ensure quality care. TheRead MoreSignificant Health Care Event - Managed Care1489 Words   |  6 PagesSignificant Health Care Event - Managed Care Health care has grown and evolved over the centuries from haphazard treatment based on tradition and superstition that often times did more harm than good, to a system that is able to preserve life in situations where life was previously believed to be unsustainable as recently as just 50 years ago. The concept of managed health care began over 100 years ago as a means by which medical care could be provided to injured workers, but has undergone majorRead MoreStrategies For Reform Throughout Managed Health Care1201 Words   |  5 Pages Aubrey Runnels 9/28/15 Summary Form #2 Group focus: Strategies for reform in managed health care Reading Sections: Chapters 34 (MW), Chapter 2 (C,CC), Chapters 3, 4,5 (J), and Ted Talks: Aaron Huey: America’s native prisoners of war 1. Summary of each assigned reading and video: Ted Talks: In the Ted Talks video of Aaron Huey, Huey makes the point that the Lakota people are now suffering due to the damage that the U.S. has done over many years. This damage includes the following: TheRead MoreThe Future Of Managed Health Care Delivery System Accountable Care Organization2609 Words   |  11 Pagesï » ¿The Future of Managed Health Care Delivery System: Accountable Care Organization Veronica L Nelson MHA 628: Managed Care Contractual Services Dr. Hwang-Ji Lu June 1, 2015 Abstract The health restructuring dispute has centered on compensating providers particularly more when delivering quality care to their patients than for enhancing the volume of services they provide (Ries, 2014) Accountable care organizations (ACOs) is a single proposed way of altering compensation methods to