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Managed Care Systems Case Study

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Managed Care Systems:
What are the economic benefits of Managed Care Systems?
The economic benefits of managed care systems are derived from providing the best quality care for a lower price. When people are able to afford healthcare and utilize it earlier, their health outcomes will be better and cost of treatment will be lower. Managed care systems allow insurance companies to be in contract with health care providers so that they can provide health care at lower prices. The ability for clients and businesses to choose their own insurance companies allows for a competitive system between insurance companies, which in turn will lower prices and increase quality.
What is the difference between Health Maintenance Organizations, Preferred Provider Organizations and Point of Service Plans?
Health Maintenance Organizations (HMO) are health insurance plans that only cover a set network of health care providers and health care facilities. HMO’s can be limiting because they do not cover outside visits unless they are emergencies. HMO’s also require the client to find a primary care provider within the network, who would be needed to authorize any specialized care if it is to be considered for coverage (eHealth, 2017). Preferred Provider Organizations (PPO) also provide a network of providers and facilities that are available for a lower cost than …show more content…

Closing this gap means better health and better outcomes for the people of Nebraska. As for accessibility, "It’s current reimbursement rates plus an increased population seeking, using Medicaid services, doesn’t necessarily equal those folks being able to get in and see providers. That’s my concern," (Knapp, 2013). Advocates of expanding coverage say covering more people will improve overall health, allow more people to get treatment, and would make state behavioral health funds go

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