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HSA-5114 US Health Care System:Analysis of Managed Care in USA

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For this assignment, you will generate, designate, Organize, investigate and, present a ManageCare Control Cost Plan: Under traditional indemnity insurance, the money follows the patient.Patients select health care providers and visit them as they choose. Providers then bill the privateinsurer or public payer and are reimbursed on a fee-for-service or per case basis.Most indemnity plans attempt to limit demand through financial barriers to the patient, such asdeductibles and co-insurance, rather than constraints on the provider. Many also require thepatient to pay the provider directly and see...

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Question Preview:

For this assignment, you will generate, designate, Organize, investigate and, present a ManageCare Control Cost Plan: Under traditional indemnity insurance, the money follows the patient.Patients select health care providers and visit them as they choose. Providers then bill the privateinsurer or public payer and are reimbursed on a fee-for-service or per case basis.Most indemnity plans attempt to limit demand through financial barriers to the patient, such asdeductibles and co-insurance, rather than constraints on the provider. Many also require thepatient to pay the provider directly and seek reimbursement from the insurer, often withpayments less than charges.Due to growing popular discontent with managed care organizations, many critics believe thatthe system will not continue in its current state. No one, however, expects managed care todisappear completely and indemnity plans to rise to their former prominence. Changes areexpected to occur as managed care programs begin competing among themselves. Cost and efficiency will no longer be the main selling point; quality of services will take precedence. Oneresearcher has suggested that along with new systems of managed care and continuing systemsof indemnity plans, health care providers may even organize and offer services directly toemployers, thus eliminating the middlemen. This development would be beneficial to allinvolved: employers would pay less; providers would be better compensated; and clients wouldreceive better care.

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Healthcare is one of the most important needs in everyone’ life, for every individual hasto maintain his/her health; and for the purpose s/he pays off the bills. But today, the expensesspent on the treatment of human health have increased to a large extent; and it has made itdifficult for a common man to afford the bills of doctors. To resolve this issue, the concept ofmanaged care plans was introduced that is a type of health insurance. The non-profitorganizations, providing managed care, have contacts or hire healthcare providers, i.e. generalphysicians, specialist doctors, etc. to provide quality healthcare at low costs for a fixed annual ormonthly fee to the people registered with them as members.

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