Challenges in Provider Relations for Managed Care

Challenges in Provider Relations for Managed Care

Introduction

Among the rich and industrialized countries of the world, US health care system is different because it carries out its purchasing, financing on the basis of private sector. The US citizens obtain their healthcare services by the insurance benefits that are offered to them by their employers. Employers get a prominent amount of tax subsidy on providing the insurance benefits to employees and their families (newsweek.com).

In an insurance system the patients are free to choose the healthcare providers for them and they pay visits to them. The providers then bill the insurer and those are compensated on the basis of fee-for-service program. The indemnity insurance plans are slowly disappearing (Acob, JA. 2000). The managed care refers to the term that a range of methods of care that is provided to the patient along with its financing and delivery. The patients are required to select any program like per-capita and per-service and are provided the services according to it. There are several managed acre plans offered to the patients (Blendon, RJ, et al).

Discussion

There are many issues that are faced in the provider relations for managed care. The most common issues are discussed below.

Conflict of interest

At the point of paying the financial incentives there are certain possibilities of the emerging of the issues of obligation. The methods of the payments that affect the pronouncement are capitation. Capitation is a process in which a fixed amount of money is paid to the provider weather they see the patient or never see him

Cost savings

Many expansions and changes occurred in the recent years in the healthcare markets which played an essential role the controlling the growth in health expenses (hcfa.gov). According to a recent study the 60% patients complained ...