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Managed Care Models

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Running Head: Managed Care Models 1
Assignment Title: Managed Care Models
Student’s Name:
Course Title:
Instructor’s Name:
Date Submitted:

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Managed Care Models 2
Introduction:
Managed care is a term that refers to a collection of insurance plans that get designed in a
manner that they offer health care for patients at manageable cost and convenience. The term is a
development in the medical sector following the increased need for specialized medical care
among patients from all walks of life (Baicker & Robbins, 2015). Though managed care plans
get perceived as plans that work for financially challenged families, the fact is that everyone
needs the managed care plans regardless of the financial background. Patients need to comply to
set rules and requirements for them to make effective use of the various types of managed care
plans (Corlette et al., 2014). The available managed care models that stand out among the entire
list include Preferred Provider Organization (PPOs), Health Maintenance Organization (HMOs)
and Point-of-Service (POS). The primary focus of this discourse is to look into the similarities
and differences of the PPOs and HMOs models.
Discussion
The Preferred Provider Organization managed care model, and the Health Maintenance
models have similarities regarding the modalities use in offering the managed care services to
patients (Tajeu, 2014). Both models involve the use of a group of care providers distributed
across several facilities. The patients in both plans benefit from cost sharing that happens as long
as they stay within the stipulated network of physicians and health care providers. In Preferred
Provider Organization model, patients who choose to refer themselves outside the defined circle
of care providers have to cater for the charges that get above the amount provided for by the plan
(Landon et al., 2015). A similar aspect of this scenario in the Health Maintenance Organization is

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Running Head: Managed Care Models 1 Assignment Title: Managed Care Models Student’s Name: Course Title: Instructor’s Name: Date Submitted: Managed Care Models 2 Introduction: Managed care is a term that refers to a collection of insurance plans that get designed in a manner that they offer health care for patients at manageable cost and convenience. The term is a development in the medical sector following the increased need for specialized medical care among patients from all walks of life (Baicker & Robbins, 2015). Though managed care plans get perceived as plans that work for financially challenged families, the fact is that everyone needs the managed care plans regardless of the financial background. Patients need to comply to set rules and requirements for them to make effective use of the various types of managed care plans (Corlette et al., 2014). The available managed care models that stand out among the entire list include Preferred Provider Organization (PPOs), Health Maintenance Organization (HMOs) and Point-of-Service (POS). The primary focus of this discourse is to look into the similarities and differences of the PPOs and HMOs models. Discussion The Pref ...
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