Managed Care Organization

To be clear, managed care are organizations that are implemented in order to reduce unnecessary health care costs by using a variety of mechanisms such as placing controls on inpatient admissions and lengths of stay, establishing cost-sharing incentives for outpatient surgery and giving patients the option of selecting less costly forms of care.

Types of Managed care

There are two types of managed care: HMOs and Fee-for-Service. HMOs are organizations where hospitals, physicians and insurance plans are in the same organization or are closely affiliated to the organization. Keep in mind; an HMO pays the doctors by salaries and owns the hospitals. Patients who are in an HMO plan have to use the plan-affiliated care provider, unless there is an emergency. One advantage that many like with an HMO plan is that they have a certain amount of money to spend on the enrollee. With a Fee-for-Service plan, patients have more freedom. Patients can choose any doctor or health care provider that they want. However, with more freedom come higher costs and patients often pay a good deal more than with an HMO plan.

Benefits of Managed Care

Possible benefits of managed care are improved facilities, an expansion of choices, money saved can be used to increase outpatient benefits, make health insurance affordable to others and reduce costs for members. The disadvantages of managed care are: continuity of care may be difficult when people get short-term treatments at different locations and if hospitalization is not given without providing other alternatives for intensive care, a patient’s symptoms may linger and worsen. Another disadvantage is a company that manages health care may change and disrupt services.

To conclude, Managed Care Organization offer various benefits but also have several drawbacks. Before choosing a managed care option, review what is available, think of health options that you and your family need and then make a decision.