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In: Nursing
What is managed care? Answer should be half-page to one page long.
What is managed care? Answer should be half-page to one page long.
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Expert Solution
MANAGED CARE.
Managed care is one of the specialized care that is mainly providing well organized health care to individuals and it mainly achieve two goals that is controlling to the health care costs and providing best quality of care to all the people. There are private as well as competitive health insurance system which will be leading to managed care to continue and provide better outcome from the system.
Managed care is a very broad term which specifically includes many types of organizations as well as insurance like health maintenance organizations, they provide a different types of services to the people for a fixed and periodic prepayment. There is another specific organization which is supporting this programme that is the preferred provider organizations which is comprising of many hospitals as well as , physicians and other providers and they can contact with an employer, insurer third-party administrator or another group to provide health care activities to covered assigned persons who has taken the specific policy.
Some of the features of managed care are
- Managed care organizations specifically achieve their goals by specialized care to the individual , holding patient access as well as removes unnecessary services.
- Specifically providing integrated health care delivery and payment systems which is well established with prepaid member fees and reducing provider fees by fixed rates for the physicians as well as for other hospital services.
- Controlling the medicine costs by providing pharmacy benefits management plans to the people.
- There is a pre-authorization and frequent utilization review provided.
- Quality improvement programs and system of payment for the physicians, hospitals as well as other providers financially accountable for the basis of cost and about the quality of medical serev that is provided to the individual
The main advantage of managed care is that it provides health care advices as well as specifically appropriate solutions for people when they seek or want to speak with a medical provider. There is immediate services can be provided and also helping people to take their care into their own wishes with a reasonable resources.
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