What is Managed Care Healthcare?

by Michele Carter-Graham on April 10, 2010

Author-Roberta Broyles, submitted by Michele Carter-Graham

There are many different techniques that are used to reduce the cost of providing healthcare to people. These techniques also help improve the quality of care besides enabling people to provide and receive services at a much lesser cost compared to normal. There are many different managed care healthcare programs from the Health Maintenance organization, the Independent Practice Organization, Preferred Provider Organization, Point of Service to Managed Care in Indemnity insurance plans.

The usual plan in managed care healthcare was that a person could get enrolled into any of the managed care programs at a small fee. Once enrolled, he or she could consult any person amongst the premium doctors on panel in each such program. In return for such treatments provided by the doctors, the government gave them access to their funds.

The different programs that are mentioned above – HMO, IPO, PPO, POS etc. are all offshoots of this basic principle with slight differences. For example in the IPO – the Independent Practice Association, the doctors that are associated with the managed care healthcare program also carry out their own healthcare practice besides the one that they provide to the people.

There are different kinds of managed healthcare types; they all work according to the same standards, but are quite different in their details. Some are more suitable to others to certain kinds of patients or situations.

The most important part of having and working with managed care is the management of risk. If you can enroll a large number of people in the program, then you are also adding the responsibility of that many people to your kitty. Any number of these people might need treatment that might cost really big.

Under the circumstances, most small organizations will not be able to survive. On the other hand if you have an organization that is really large with a huge number of people enrolled into the program then it will be able to manage the finances better in the circumstances.

This is why for any managed care healthcare program, risk management is a very important thing that needs to be understood and taken care of. Risk management, especially financial risk management programs need to be implemented from the grass root level in such organization as that is the only way they can actually afford to and be able to provide low cost health services to people.

The impact of the managed care healthcare program on the patients’ lives is still a point of debate. Its proponents believe that it has increased the efficiency of treatment whereas those against argue that it has in fact increased the cost of care by nearly 25-30% for patients.

No site but HealthcareRiskManagementGuide.com gives you all the tips and info on private health care and related subjects. Whether you are a newbie or an expert, make sure to check out risk analysis by following the links above!

Article Source: http://EzineArticles.com/?expert=Roberta_Broyles

About Michele:
Michele Graham is the CEO of Professional Healthcare Management, a leading provider of medical business management services. Professional Healthcare Management started in 2003 and offers services to all medical professionals for credentialing and insurance contracting. We have performed services for over 3000 providers and multiple hospitals, surgical centers and wound care centers. Our fees are competitive and our staff is comprised of experienced professionals with years of experience in the healthcare industry. Michele has over 40 years experience in healthcare and we welcome anyone having issues getting contracted or getting paid. We try and negotiate better reimbursements for each and every provider....call for more information!

{ 1 comment… read it below or add one }

Vera April 8, 2015 at 4:24 am

The Name change is NOT suspirring, because you are seeing that there was a NEED to shift your companies emphasis to stay relevant to what is happening in the Dental Market place. Your survival and the average Dentist’s survival are intertwined; or you can HANG together. I have been following your company and am glad that you finally saw the LIGHT! Times are TOUGH and you have to be realistic! We can all think of the GRRReat times of the past, but being in my sixties I have been aware of the ups and downs of the Dental economy. Good luck with the shift, you definitely will have more offices seeking your services.

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