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Managed Health Care: Similarities And Differences

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Define, compare and contrast fee-for-service and managed health care plans. What are the similarities and differences? Support your response with one citation and specific examples.
Fee for service plans
“Fee-for-service plans contain a variety of stipulations designed to control costs and to limit a covered individual’s financial liability” (Martocchio, 2014, p. 147). This agreement is that the consumer pay individually for each aspect of the goods or services receives. Specific choice is a crucial aspect of a fee-for-service agreement. Specific choice allows for personal tailoring of products and services. A fee-for-service agreement allows patients to pay for each instance of care, such as basic doctor 's office visits, dentistry services, …show more content…

Your choice of providers may be limited to those within the network, or your out-of-pocket costs will be lower when you obtain services from providers within the network. A managed care plan is an arrangement with a selected network or group of organizations; it is evolved as a way to reduce the cost of health care and improve the quality of care using a variety of techniques. In other words, managed care is a technique to bring the health insurer, health care providers, medical facilities as well as the individual who wants to be insured just under one umbrella. Under fee for service plans this type of health plan, the health insurer is liable to pay the claimed bills of health care services provided to a policyholder.

Similarities and differences
FFS, you can go to see any physician you want, whenever you feel it is necessary. Under managed care there is a strong financial incentive to see only those physicians who are affiliated with the plan. With FFS, you might not have to wait long to get a non-emergency appointment, but you 'll probably spend some time in the waiting room. Under managed care, according to a Consumer Reports survey, members of HMOs have to wait a little longer to get a non-emergency appointment, but their wait is shorter once they 're at the doctor 's

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