FACTORS TO BE CONSIDERED BY HCP



Factors to be Considered by HCP

Factors to be Considered by HCP

Of the approximately 257.8 million individuals currently living in the United States of America, every one of them has a need for effective, affordable and accessible health care coverage and services. Within the past thirty to forty years, the scope and cost of health care coverage and services has drastically changed, altering the manner in which health care was previously managed.

There are several factors that have affected the cost of health care coverage over the course of the past two to three decades. One of these factors is the introduction and rapidly increasing enrollment in managed health care insurance plans. Managed care health insurance plans can, in most cases, help to alleviate the rising costs of effective medical coverage.

Another important factor that has affected health care costs is the invention and implementation of new medical technologies. As prominent researchers and economic analysts have discovered, there is a distinct and direct correlation between advancing medical technologies and rising health care costs. Medical innovation has been proven time and again to be an important determinant of health care cost growth. It would appear that managed care health insurance plans, which attempt to lower health care costs, and highly expensive new medical innovations and procedures are at cross purposes, pulling against one another in very different directions.

Helathcare providers (commonly known as HCPs) have emerged as the clear leader of managed care providers. Other types of managed care plans include preferred provider organizations; point of service plans and managed indemnity plans. Most studies focus on HCPs and so do not describe variation in the type of HCP or in the extent of the level of management in non-HCP plans. HCPs have effectively reduced health care expenditures.

A natural assumption would be that the quality of care would be lowered as insurance rates go down and remain reasonable and affordable. However, these cost savings have been achieved, according to most evidence, without significant reductions in the quality of care. This suggests that managed care health insurance plans -HCPs in particular- tend to reduce inefficiencies in the health care system. In fact, a study that examined changes in hospital expenses in California found as much as a forty-four percent slower rate of hospital care cost growth in markets with high HCP penetration relative to markets with low HCP penetration. Then why do HCPs get such a bad reputation?

There are two main types of services that managed care health insurance companies use to categorize and label their treatments and procedures. These categories are known as "complementary services" and "substitutive services". These two terms apply to new innovations in medical technology and the amount of money spent to provide the technology to the consumer. Complementary services are those whose use increases with the use of the new technology. Complementary services are attractive to the consumer, who, understandably, desires the latest, most effective medical technology to treat themselves and their loved ...