The Advantages of Managed Care Health Coverage
Managed health care is a term referring to the methods or systems used to reduce the costs of medical services and improve health care quality for users. Managed health care services revolve around the concepts of cost containment by means of cost-sharing between member-plan holders and service providers, organized payment and payout schemes, controlled enrollment or membership, pre-selection of services and incentives for in-network patronage.
Managed Care Organizations
Managed care was pioneered by health maintenance organizations (HMO) through the enactment of the HMO Act of 1973. In 2009, more organizations in addition to HMOs are providing managed care services. These organizations include preferred provider organizations (PPO), point of service (POS), exclusive provider organization (EPO), high deductible health (HDH) and self-directed health (SDH), among other groups.
Enrollment
The managed care industry in the United States boasts about 1000 companies as of 2009. Statistics from the Health Leaders Inter Study indicate that in 2009 alone, a total enrollment of 126.4 million will be registered in managed care. When medical costs increase, more people look to managed care services to minimize their medical expenses.
Reduced Costs
The basic concept for managed care is cost-containment by employing an organized network of service providers and meeting them with pre-selected plan holders under a cost-sharing agreement.
Focused Health Care
Because managed health care is not only co-paid but co-managed, the focus is trained only on necessary services that can lead to a more effective service delivery.
Better Managed Health Care
Health care organizations, being concentrated to their network, are not only able to identify the necessary services, but are able to utilize more efficient management systems. This can mean that service delivery will be more appropriate to the conditions of the patients.
Flexibility
Patients and plan holders may opt for out-of-network services if necessary. Health care plans are varied in coverage as well as cost. Members are given the option to choose their type of coverage depending on their affordability.
Security
The greatest advantage of managed care health insurance coverage is the feeling of security provided by the guarantee that whatever medical needs will arise, costs will be within control because proper management have been arranged and provided for.
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