Types of managed care plans. Introduction: Healthcare can be defined as the efforts made by licensed and trained professional to restore or maintain emotional, mental and physical well-being. In other words, healthcare is about improvement and maintenance of health by recovery, treatment, prevention of injury, illness or diseases. Health management organization also known as HMOs is a type of managed care plan that make use of discounted schedule of rates for providers, should receive a referral for specialist, keep a track on visit of patient to restricted healthcare providers and provide incentive towards proactively taking action to prevent illness. The treatment under HMO are provided on a prepaid basis wherein a monthly fee also known as premium is paid by individual and care is provided for entire month. Health management organization only make payment towards the health care services within its network and does not provide cover outside its network. Preferred provider organization refers to the arrangement that provides medical care wherein subscribed clients are provided with medical facilities and professional care at subsidized rates. The healthcare and medical professional that provides their services to preferred provider organization are known as preferred providers. Unlike Health management organization, no prepayment is made by the members, the payment is made at discounted rate when the services are rendered. Preferred provider organization provides more coverage within its network, however unlike health management organization healthcare providers, hospital and doctors can also be used but with an additional cost. It can be concluded that the type of managed care plans are health management organization and preferred provider organization.

EBK HEALTHCARE FINANCE: AN INTRODUCTION

6th Edition

ISBN: 9781567937428

Author: Gapenski

Publisher: YUZU

See similar textbooks

Concept explainers

Trends in the Industry

We all know that we live in a dynamic environment that keeps changing with no break. Earlier, we used to visit banks for any work, but now you can do any work online. Similarly, shopping is also no more physical. You need an excuse to buy something, and …

Expert Solution & Answer

Want to see the full answer?

Check out a sample textbook solution

See solution

Chapter 2, Problem 3.1STQ

Chapter 2, Problem 4.1STQ

Students have asked these similar questions

what are the primary cost saving features of a managed care plan?

Have we made the payment structure of health care to complicated?

what is medicare

Knowledge Booster

Learn more about

Need a deep-dive on the concept behind this application? Look no further. Learn more about this topic, finance and related others by exploring similar questions and additional content below.

Similar questions

Recommended textbooks for you

Pfin (with Mindtap, 1 Term Printed Access Card) (...
Finance
ISBN:9780357033609
Author:Randall Billingsley, Lawrence J. Gitman, Michael D. Joehnk
Publisher:Cengage Learning
Personal Finance
Finance
ISBN:9781337669214
Author:GARMAN
Publisher:Cengage
Principles of Accounting Volume 2
Accounting
ISBN:9781947172609
Author:OpenStax
Publisher:OpenStax College
Administration Of Wills/Trusts/ And Estates
Finance
ISBN:9781285281308
Author:Brown
Publisher:Cengage