How Managed Care Works

Bls certification

Managed care is a system intended to help decrease unnecessary costs that come with health care through different mechanisms. These mechanisms include economic incentives for physicians and patients to choose less expensive forms of health care, increased beneficiary cost sharing, selective contracting with different health care providers, along with a few others. The initial growth of managed care was brought on by the enactment of the Health Maintenance Organization Act of 1973.

Managed care review can vouch that managed care plans have subdued medical cost inflation in the late 1980s by making the health care industry to become more efficient and competitive by reducing unneeded hospitalizations and making health care providers to discount their rates. These changes help with revenue recovery previously lost from unnecessary health care costs.

For those that participate in managed care, payment reviews are generally positive. A managed care review shows that depending on the type of managed care chosen impacts the payment compliance necessary. PPOs are the least expensive kind of coverage because of the patient paying for a substantial portion of the first dollars coverage. HMO is a coordinated system that combines both financing and delivery of health care for those that are enrolling. For those that are confused, the Point of Service or POS plans let the patient choose between either HMO or PPO each time that they are in need of care. Managed care review can be confusing when first figuring out the system, but once it is figured out, the benefits become clear for the patient or client.
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