Evolution of Health Care

HCS/531
August 27, 2012
Russell Arezz III

Evolution of Health Care
Congress adopted the Health Maintenance Organization Act in 1973 that financed start-up costs for managed care companies and mandated firms with 25 employees or more to offer traditional health insurance. These provisions were terminate in 1995, but by this point health maintenance organizations and other managed care organizations were established in companies around the United States.

Identify the Subject

Managed Care is a form of health insurance that supplies inclusive medical care, which is established on a contract, paid in advance as opposed to traditional fee-for-service health insurance. Traditional health insurance pays a health care provider when services are needed. Managed -care plans pays a health care providers a fee monthly for every member of the plan, regardless of whether the member requires medical care or not.

There are three basic types of managed care organizations: health maintenance organizations (HMOs), preferred provider organizations (PPOs), and point of service (POS) plans ("About Managed Care Health Plans," 2012). Managed care organizations contract a certain number of plans to providers in each service area.

Health maintenance organizations (HMOs) provide a simple supplemental health maintenance and medical services to members who pay in advance a fixed periodic fee is set without regard to the cost or type of services received ("Health Maintenance Organization Plans, " 2012).Plus diagnostic and treatment services, involving hospitalization, and surgery, an HMO often offers additional services, such as dental, mental, and eye care, and prescription drugs. The advantage of health maintenance organizations is this type of medical care annual premiums are less expensive the cost of care is distributed between the members. P...

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