Managing Healthcare in America

Managing Healthcare in America

Introduction

Managed Care Organizations have the sole purpose of providing healthcare services at low costs but high benefits and quality. In U.S., it works to inculcate a number of techniques to shrink the costs. It works as a third party that shape up services for other organizations. We offer the organizations with a multiple mix of services and heads against which they can operate their own services. It took its growth with the enactment of the Health Maintenance Organization Act of 1973. Now many private sectors also use them to improve their settings. Although there is divided opinion for its success to control costs, private organizations still take help from MCO plans (Musgrave, 2006).

Discussion

My employers offer a number of Medicare services which aim to provide patients with maximum health and save the company's costs. Below are the services which we offer:Choice of Doctors and Other Contributors

Employee Cost Sharing and Premium Contribution

It is often a confusing activity to select the right group of doctors for the hospital. Hospitals usually have a network of doctors and other contributors in case they need them in an emergency. We have qualified induction of doctors to excel Medicare services. Yet, in case when those doctors are not around we have another option, which is POS. It stands for “Point-of-Service Option”. POS members have no choice to avail which ever procedure, instead, it is decided the point at which someone requires the services. This is a very effective plan; however, it demands patient's capability to contribute financially. For instance, when the patient wishes to stay in our providers' network and ask for referrals to have specialists, it results in a condition of co-payment. On the other hand, when they will use provider out of the network but do not ask for referrals, they will have to bear larger payments on their sides. The implications for the plan bear the lacking of permanent availability of doctors and providers. It sometimes may cause chaos as to refer to which doctor at the time of and whether the doctor is available or not (Musgrave, 2006).

PPO (Preferred Provider Organization) offer cheaper rates than the normal ones form the professional doctors and providers because of their partnership with the company. Adopting PPO system scores money when they charge a provision fee to the insurance company because they are now part of their network.

Access to Specialists and ...