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Pros And Cons Of Managed Care

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Three Major Criticisms/Drawbacks of Managed Care
When it comes to managed care, the rules are extremely rigid. In this system a person’s options are very limited when it comes to selecting one’s own doctor. Even if a person is not content with the care that they are receiving, they may not have another in-network healthcare provider that can be reached through their HMO or PPO. Therefore, if a person wants to seek a second opinion, they are forced to go out of their network, furthermore, their insurance will not pay for that expense (Vittana.org, 2017).
Managed care limits care access for those individuals who lack insurance or provider coverage. If a person is poor and residing in a system with managed care, then their options are limited. Many people living in this situation are normally forced to go to an emergency room for care for the reason that it cannot be denied there. It is almost impossible to find a provider in private practice, regardless of sliding scale fee schedules, when they lack the ability to pay for health care services (Vittana.org, 2017). …show more content…

Most of the complaints presented by patients in this system usually involve unreasonable services being provided by medical providers. Many patients complain that their doctors order unnecessary tests to maximize the billing that can be submitted to their insurance. Some patients complain that their doctors decline to order tests that may be required to avoid needing to send them out-of-network for care. Add in the pre-authorizations that an insurance provider may require before a treatment can begin and it makes health care seem like patients are products instead of people (Vittana.org,

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