Question

In: Operations Management

Describe the principles of fee-for-service plans and managed care plans. What are the similarities and differences?

Describe the principles of fee-for-service plans and managed care plans. What are the similarities and differences?

Solutions

Expert Solution

The service plan fee is based on the following:

Payment independently for all services rendered in the hospital.
Give patients the right to choose physicians, nurses, and services available.
After full service is rendered, payment shall be made to the service providers.

The Managed Care Plan:

Stresses restrictions on the choice of nurses and physicians.
Limits the budget to allow for an affordable and reliable service to the patient.
Managed health care organizations are responsible for supervising medical services financing.

The difference is the following:

Patients have the freedom to choose the doctor because of the service schedule fee. The managed treatment plan, on the other hand, can only be managed by the associated physicians.
The fee for the plan does not limit the services and the costs to be rendered. The managed care plan restricts the amount to be spent and only requires visits.
The service charge emphasizes customer satisfaction while the controlled care plan limits customers ' views through several surveys, as cost-effectiveness is the primary objective.
The following similarities are:

Both are payment plans for medical care.
Both offer payment options as well as anticipated services.


Related Solutions

Discuss how switching Medicaid and Medicare beneficiaries from the fee-for-service (FFS) system to managed care plans...
Discuss how switching Medicaid and Medicare beneficiaries from the fee-for-service (FFS) system to managed care plans affects healthcare utilization, costs, and outcomes.
Review managed care contracts for different payment plans (PPO, HMO, Fee for services, etc.) and describe...
Review managed care contracts for different payment plans (PPO, HMO, Fee for services, etc.) and describe provider incentives and risks under each of the following reimbursement methods: Cost-based Charge-base (including discounted charges) Per procedure Per diagnoses Per diem Global pricing Capitation
The managed care system emerged as the alternative payment and delivery mechanism to traditional fee-for-service indemnity...
The managed care system emerged as the alternative payment and delivery mechanism to traditional fee-for-service indemnity insurance. Discuss how managed care organizations work. What do all managed care organizations have in common?
Discuss the differences and similarities between Managed Care Organizations (MCOs) vs. Accountable Care Organizations (ACOs). Given...
Discuss the differences and similarities between Managed Care Organizations (MCOs) vs. Accountable Care Organizations (ACOs). Given the current health care environment, provide a solid speculation to how MCOs and ACOs may transform to meet the needs of its consumers. Be sure to support your thoughts and analysis with scholarly sources.
US HEALTHCARE Managed Care For years, your parents had a traditional fee-for-service health insurance. They are...
US HEALTHCARE Managed Care For years, your parents had a traditional fee-for-service health insurance. They are now required to switch to a managed care product. They are very upset because they love their physicians. However, their physicians did tell them they had contracted with certain MCO's to provide services. You parents were still confused. Explain the managed care principle, and which program would enable them to use their practitioners.
Managed care plans tend to lower health care costs, yet the level and growth of managed...
Managed care plans tend to lower health care costs, yet the level and growth of managed care premiums are similar to those of traditional fee-for-service insurance plans. How can that be explained?
what are some of the principles of managed care practice that make expand partnerships between Medicare...
what are some of the principles of managed care practice that make expand partnerships between Medicare Advantage D-SNPs and Medicaid MLTC plans is good?
What are some of the key differences between traditional health insurance and managed care?
What are some of the key differences between traditional health insurance and managed care?
Explain why the U.S. healthcare system has transitioned from a fee for service to a managed...
Explain why the U.S. healthcare system has transitioned from a fee for service to a managed care system and now to one who’s reimbursement system rewards quality outcomes
Describe the similarities and/or differences between the following (at least 4 similarities or differences for each):...
Describe the similarities and/or differences between the following (at least 4 similarities or differences for each): production of ATP in oxidative phosphorylation and production of ATP in the membrane associated (light) reactions photosystem I and photosystem II citric acid cycle (Kreb cycle) and Calvin cycle
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT