Hca230_Week_1_Assignment

HCA230 Week 1 Assignment Today Managed Care is the most predominant form of insurance in the United States. Insurances such as PPO, POS, and HMO plans are all included as managed care. Unfortunately many doctors’ offices have to rely on managed care insurances to stay afloat because traditional insurances are in a way being phased out. Both types of insurances come with positive and negative outcomes. The advantages of managed care plans are lower co-payments. Usually the patient knows exactly the amount they are expected to pay for their services. These predetermined amounts depend on the type of plan you get and vary depending on the service. Another advantage of managed care is that these insurances usually make the medical decisions and offer a wide variety of professionals to choose from to seek the medical attention you need. Physicians understand the importance of quality of care and strive to make sure you have a good experience. Managed care believes in preventative health, therefore, every year your well visits are covered ranging from dental visits to eye exams and your yearly physicals. Another key advantage is the prescription drug programs managed care has. They typically offer lower rates for prescription drugs because they can prescribe a formulary or generic version which is cheaper to produce, therefore, cheaper for the consumer. Disadvantages for having the managed care insurance is that the insurance company tells you who you can and cannot see depending on your geographical area. They also put limits on your treatment with how much they will pay and you have to see your primary care physician first and they tell you if you are allowed to follow up with a specialist. Another danger is your medical records are available for other medical professional staff other than doctors. Incentives which are good for the patient are not so good when related to the physicians and can limit treatment as well. From a consumers perspective managed care and traditional insurance comes down to the financial aspect. With traditional insurance a deductible is required, along with monthly premiums, and 20% of medical bills that go over the deductible. With managed care they do not require a deductible and do not require you to pay your medical bills. Managed care requires monthly payments plus any co-payments you may have. From a caregivers perspective there are many options to look at besides traditional insurance and managed care insurance because under managed care insurance comes a few different types that vary regarding pricing for both patients and their incentive programs. Managed care programs however offer a more stable patient load and income level that is more dependable to run a practice. Managed care helps with the expense of maintaining the facility and the faculty. Disadvantages include loss of professional independence and an increased financial risk. Capitation is another huge risk because providers are paid a set amount no matter how much care is provided to the patients. If I had to choose a health insurance plan between managed care choices and traditional insurance I would have to choose managed care insurance. Even with some disadvantages as being told what doctors are in my network to see with the current economic state I cannot afford a high premium along with a deductible and then if something should happen be able to pay 20% of the medical bill. Managed care insurances overall are still more beneficial in my opinion and until traditional insurances compete more I feel it will stay that way.