Managed Care Policy Analysis

Healthcare has changed dramatically over the past few years. With the development of the Patient Protection and Affordable Care Act (PPACA), 2010 and the expansion of Medicaid in 2012, many Americans are to afford health insurance. Since it is a requirement that everyone has health insurance, the issue lies with which plan should one choose or how much they are willing to pay for it. There were many reasons as to why Health Maintenance Organizations (HMOs) were formed in the first place. First, physicians wanted to maintain and increase patient revenues. Many of the physicians believed that they were a threat to “organized medicine”. In 1932, the American Medical Association (AMA) adopted a strong position against prepaid group practices,

Since HMOs were the first typed of managed care developed, the government had a hard time going along with it. With the development of the Health Maintenance Organization Act of 1973, the government was reluctant to issue rules and regulations of the act. The slowness of the federal government in issuing the regulations implementing the act also delayed HMO development. Employers knew that they would have to contract with federally qualified plans (Kongstevdt, 2009, p.5). Employers who chose to use the federal qualified plans gained access to those funds earlier than others who didn’t choose those

The most recent significant development is the rise of the consumer-directed health plan (CDHP), including such variants as health savings accounts (HSAs) and other types of high-deductible health plans (HDHPs) (Kongstvedt, 2009, p. 15). Consumer-directed health plans helps to reduce health care spending by choosing less expensive health services. Health savings accounts are health savings for individuals who are enrolled in high-deductible health plans (HDHPs). HSAs are exempted from federal tax income. High-deductible health plans are not like regular health plans. They are high-deductible plans with lower premiums. The managed care industry is working hard to provide insurance plans that would cater to people. For example, a young adult, who is in good health and would probably only visit the doctor once or twice a year, would choose a catastrophic plan, whereas a family of 4 would choose either one of the 4 types of plans (HMOs, PPOs, HSA, or HDHPs). Choosing a plan is based on the person and/or families’