Essay on "Financing Structuring Health Care"

Essay 3 pages (933 words) Sources: 4

[EXCERPT] . . . .

For the patients this will translate into lower premiums and better coverage. The drawbacks of this kind of plan include: less choices for patients. This is because the health care provider and insurance carriers can have restrictions on certain kinds of doctors and treatments. In the event that someone is very ill, these kind of delays could make their underlying condition worse (leading to a reduction in the quality of care). ("Basic Types of Managed Care," 2009)

A PPO is providing patients with better choices and more services. For health care providers and insurance companies, this is assisting them to be able to streamline costs. As they can use their network of physicians to find someone that can provide the services patients require at an affordable price. In the case of the insured, this is offering them with the ability to find those solutions that will address their needs. The drawbacks from this form of managed care include: higher costs for the insurance company, health care providers and policyholders. Moreover, the insured will have larger deductibles and premiums they are paying. ("Basic Types of Managed Care," 2009)

A POS is giving the insurance company, health providers and patients with more choices. This helps to reduce the costs for all three stakeholders. However, the drawbacks of using this kind of plan are that any kind of coverage outside of the network will not be honored by the insurance company. This is because their costs are much higher from using another health care provider. As a result, this forces insurance carriers and health organizations to place restrictions on the activities of patients. ("Basic Types of Managed Care," 2009)

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