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Assignment #5 Overview:
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Explanation & Answer
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MANAGED CARE PLAN
Student Name:
Assignment #5 Title
Benefits Offered and Services Covered
Cost vs. Benefits
1
Health Choice/ Maryland Managed Care
Plan
The managed care plan selected is Kaiser
Permanente. Some of the questions to ask to
determine the benefits covered and services
offered by the Kaiser Permanente include:
What is the compensation model? Does the
health plan evaluate plan designs and costs of
several insurance carriers? What types of
products and design options are provided?
Does the plan handle a broad portfolio of
products? Does the plan have solid bona
fides? Are routine examinations such as
mammograms and pap tests required?
The Kaiser Permanente is seen as the face of
the future health care in the US. The Kaiser
Permanente offers insurance and prepaid
health plans to individual members,
employers, and employees, (Paxton, 2012).
The Kaiser Permanente consists a non-profit
plan that invests in the Kaiser Foundation
Hospitals and provides infrastructure for the
foundation. The plan also offers a tax exempt
shelter for for-profit medical agencies. The
Kaiser Permanente is believed to have four
distinct characteristics. These include
prepayment where 90% of the pan`s revenue
is prepaid allowing the health plan to align
with client incentives. The Kaiser Permanente
is a vertically and horizontally integrated
structure across medical groups, inpatient and
outpatient care and the specialty care,
(Paxton, 2012). The Kaiser Permanente has a
built culture of physician leadership. Finally,
the Kaiser Permanente has advance...