Monday, August 12, 2019
Managed Care Essay Example | Topics and Well Written Essays - 3000 words
Managed Care - Essay Example emerged in this modern world and the employers in the present day context get involved in making as well as executing an effective plan with utmost focus on paying premiums. These premiums are paid by the workers in the form of deductibles, copayments as well as through contribution. It has been apparently recognized that this changed system of healthcare has transformed the investment pattern of the employees. In the year 2013, highest number of employees was recorded to be enrolling in the Preferred Provider Organization (PPO) plans. The same has been illustrated in the form of the following chart: Managed care has proved its dominance in providing ââ¬Å"qualified health plansâ⬠with the aid of different health insurance organizations. Specially mentioning, there is a need to follow the rules that are provided under the Affordable Care Act. The ACA prescribed system of medical loss is noted to be limiting the percentage of premium revenue for enhancing its use for administration, marketing as well as attaining maximum profit. However, to increase the transparency within the system, more regulations are required to be incorporated by the respective government. To increase the competition within the domain of healthcare aid, there are various additional developments being initiated to incorporate within the domain of healthcare based operations. This competitive edge is being developed with the notion to enhance the control over the premium rate fluctuations (Shi & Singh, 2011). ACA visualizes that Consumer Operated and Oriented Plans (CO-OPs) will be developed based on finances received from the federal government. This type of plans is available in small numbers within the US Medicaid services. CO-OPs started operating as nonprofit making organizations following the developments such as the Health Maintenance Organization (HMO) and PPO. CO-OPs are even structured based on standard models of such organizations that have been already active within Medicaid
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