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Predicting Future Hmis Trends by Chief Information Officers

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Managed Care
Staci Berry
MHA614 Policy Formation & Leadership In Health Organizations
Instructor: Judy Roberts
April 2, 2013

Managed Care In this paper we will discuss managed care. We will find and discuss the definition of managed care. This paper will also explain the different types of managed care plans that are available to Americans. This paper will provide examples of the different types of managed care plans available. It will also explain how each plan works. We will also talk about why rising exposure to health care costs are threatening the well-being of American families. According to Harrington and Estes, managed care is a term that has been overused and really does not have a specific meaning. “Originally, it referred to health care delivered with a capitated financing mechanism. Then it included health care delivered through contracting networks. Currently it refers to most any health are delivery that is different from fee-for-service health care delivery” (Harrington & Estes, 2008 pg.42). When dealing with managed care usually there is a panel of providers that the individual can use. If they go outside of this panel they will be more likely to have to pay a higher copayment or deductible. Some characteristics of a managed care health plan delivery system include: “explicit standards for the selected health car providers, it also puts emphasis on preventive care, as well as provides financial incentives to ensure the use of the services offered by the managed care organization, there is also a select group of health care providers that provide the comprehensive array of health care to individuals, lastly it has a regular set of utilization review that aims to help improve quality of their programs” (USACoverage, p3). When looking at managed care plans there are several different plans available. There are HMO,

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