According to James Henderson (2012), “Managed care is a term used to describe any number of contractual arrangements that integrate the financing and delivery of medical care”.
There are three common types of managed care plans: Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), and Point-of-Service (POS). One of the upsides to managed care is that many health insurance plans operate with the use of a wide range of physicians and specialists who are connected with the insurance provider’s network.
Health Maintenance Organization (HMO) is a company that provides health care plans. It provides medical care from an approved network of hospitals, doctors and pharmacies. In this plan, the patient will need to pay a …show more content…
In a group model HMO, the organization does not pay the physicians directly, but pays a group. The group then decides how to distribute the money to the individual physicians. Within a staff model HMO, the physicians are direct employees and salaried for the Health Maintenance Organization, for example, a group of physicians often within the same building or clinic. However, a network model HMO is an HMO that will work with any combination of groups, hospitals and physicians. Lastly, Individual Practice Association (IPA) is a contracted independent doctor, some will call this doctor the neighborhood doctor, they solely work by …show more content…
However after further reading and research I have learned that part of the premium goes to the organization to take care of the individuals whether you are at the doctor or not, they seem to be more focused on preventive care. Whereas, the Preferred Provider Organizations (PPO), is more so a network of doctors that have agreed to give discounts through insurance companies and able to see them at any time without being referred and most importantly my favorite the Point-of-service managed plan, which is a more preventive care plan with more flexibility. I do not believe that one plan is better than the other, it just depends on what you want and how you want to go about your doctors visits. If you prefer going to one set doctor at all times Health Maintenance Organization is probably the plan for you, whereas, if you just want to go straight to a specialist, the Preferred Provider Organization is the best
There are three common types of managed care plans: Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), and Point-of-Service (POS). One of the upsides to managed care is that many health insurance plans operate with the use of a wide range of physicians and specialists who are connected with the insurance provider’s network.
Health Maintenance Organization (HMO) is a company that provides health care plans. It provides medical care from an approved network of hospitals, doctors and pharmacies. In this plan, the patient will need to pay a …show more content…
In a group model HMO, the organization does not pay the physicians directly, but pays a group. The group then decides how to distribute the money to the individual physicians. Within a staff model HMO, the physicians are direct employees and salaried for the Health Maintenance Organization, for example, a group of physicians often within the same building or clinic. However, a network model HMO is an HMO that will work with any combination of groups, hospitals and physicians. Lastly, Individual Practice Association (IPA) is a contracted independent doctor, some will call this doctor the neighborhood doctor, they solely work by …show more content…
However after further reading and research I have learned that part of the premium goes to the organization to take care of the individuals whether you are at the doctor or not, they seem to be more focused on preventive care. Whereas, the Preferred Provider Organizations (PPO), is more so a network of doctors that have agreed to give discounts through insurance companies and able to see them at any time without being referred and most importantly my favorite the Point-of-service managed plan, which is a more preventive care plan with more flexibility. I do not believe that one plan is better than the other, it just depends on what you want and how you want to go about your doctors visits. If you prefer going to one set doctor at all times Health Maintenance Organization is probably the plan for you, whereas, if you just want to go straight to a specialist, the Preferred Provider Organization is the best