Managed Care History

The History and Types of Managed Health Care Plans and Other Insurers

Managed care plans and other insurers: By better understanding the past and present of managed care plans and other insurers in the USA, we can make well-grounded statements about its challenges and proper ways of answering them; furthermore, having a health care plan can help to help improve your chances of getting medical treatment to control and reduce the risk of sickness and disease.

Introduction
Discussion
I. History of health care plans
A. The goal of health care plans
B. When health care plans started forming
C. Who were the first to start health care plans

II. Types of health care plans
A. Private Health Insurance
1. Fee-for-service
2. Managed
According to fee-for-service system, a doctor provides a medical service to a patient, and the patient, accordingly, pays for that service certain amount of money. So, the amount of payment is directly dependent on the amount of service. In health care plans, fee-for-service system means that health care providers are being paid by insurance organizations for each service they have provided to a patient. During the first half of the 20th century, fee-for-service model of health insurance was considered the most convenient by patients, doctors and insurance companies. The reason for this is because that it was the traditional or norm way of receiving care and there were not many plans to choose
The main point of managed care consist in lowering costs of health providers’ services by means of negotiating with many providers for better prices, creating incentives for physicians and specialists, and establishing selective contracts with hospitals and health care providers. In this system, patients do not pay for each separate service provided to them, but for the whole bulk of services which is conditioned by health insurance organizations. By creating branched networks of hospitals and health care providers and combining financing and delivery of health care, HMOs obtain better prices for their clients and make health care plans more flexible. Moreover, in most HMOs each patient is connected to a primary care physician who is responsible for providing diagnostics and transferring patient to different specialists. At the same time, downside of HMOs consists in the fact that patients’ choice of health care providers is somehow limited, as he/she can choose only among those which are members of a network of a certain HMO (Bihari,