Pros and Cons of Mco
Pros and Cons of Managed Care in America
1) Public Sector: Federal and State Programs: * Medicare: A federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease. (www.medicare.gov) Medicare consists of different parts that help cover specific services: Medicare Parts A, B, C and D, which respectively covers hospital and medical insurance, Medicare Advantage Plans and prescription, drug coverage (in order). * Medicaid: Provides health coverage to nearly 60 million Americans, including children, pregnant women, parents, seniors and individuals with disabilities.
2) Private Sector: What makes the United States’ healthcare diverse is the mixture of private healthcare providers. It also diversely responds to the needs and wishes of various ethnic, racial and religious backgrounds of millions of people who make up the United States population. More than 67% of Americans (more than 200 million people) were covered by private health insurance in 2007 alone (www.galen.org).
What is Managed Care? Managed Care is defined as “a system of health care in which patients agree to visit only certain doctors and hospitals, and in which the cost of treatment is monitored by a managing company” (www.google.com). “Gatekeepers” are designated and assigned various tasks of guiding members through a network of insurance plans designed to provide quality care at the lowest possible costs. Although Managed Care is known for its restrictiveness, it still covers an extensive range of healthcare services while offering a lower out-of-pocket expense to consumers as long as he or she stay within the range of his or her assigned network of providers.
(how it works) Sub-point 1: How Managed Care works Sub-point 2: Types of Managed Care Plans A) Health Maintenance Organizations (HMOs) B) Preferred Provider Organizations (PPOs) C) Point – of – Service Plans (POS)
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1) Public Sector: Federal and State Programs: * Medicare: A federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease. (www.medicare.gov) Medicare consists of different parts that help cover specific services: Medicare Parts A, B, C and D, which respectively covers hospital and medical insurance, Medicare Advantage Plans and prescription, drug coverage (in order). * Medicaid: Provides health coverage to nearly 60 million Americans, including children, pregnant women, parents, seniors and individuals with disabilities.
2) Private Sector: What makes the United States’ healthcare diverse is the mixture of private healthcare providers. It also diversely responds to the needs and wishes of various ethnic, racial and religious backgrounds of millions of people who make up the United States population. More than 67% of Americans (more than 200 million people) were covered by private health insurance in 2007 alone (www.galen.org).
What is Managed Care? Managed Care is defined as “a system of health care in which patients agree to visit only certain doctors and hospitals, and in which the cost of treatment is monitored by a managing company” (www.google.com). “Gatekeepers” are designated and assigned various tasks of guiding members through a network of insurance plans designed to provide quality care at the lowest possible costs. Although Managed Care is known for its restrictiveness, it still covers an extensive range of healthcare services while offering a lower out-of-pocket expense to consumers as long as he or she stay within the range of his or her assigned network of providers.
(how it works) Sub-point 1: How Managed Care works Sub-point 2: Types of Managed Care Plans A) Health Maintenance Organizations (HMOs) B) Preferred Provider Organizations (PPOs) C) Point – of – Service Plans (POS)
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