Managed Care Plans for the Insured
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Managed care plans for the uninsured
Aisha Jones
Managed Care and Health Insurance-HEA 205
Professor: Dr. Christine Connolly
January 19, 2013
Abstract This paper is about an article I read about how managed care plans were created for uninsured patients of New Mexico back in 1997. The University of New Mexico Health science center felt that if they created this managed care plan that it would reduce the use of the emergency room and cost of care for the patients. By utilizing preventive care services this would actually decrease the unnecessary use of the emergency room for preventive and non-urgent care.
Managed care plans for the uninsured:
A program like this is very necessary in areas of which many people have no health coverage at all. When people do not have health coverage they tend to go straight to the emergency room for things regular things such as a cold or just to check and make sure they are ok. Most emergency rooms cannot deny you from care. When uninsured patients do this they are then billed and never pay the hospital they lose out on money for services that they had to provide. Repeated use of the emergency room becomes costly to any hospital. With a managed care plan in place for the uninsured they would be able to utilize the plan for preventive care and urgent care. Studies show that when patients have access to preventive care the will be less likely to go to the emergency room for services that they can just go to their primary care physician for. I think they would come out a lot cheaper having a plan like this where everyone can receive the proper health care service they need. This takes a lot of planning and budgeting of the state/county and the facility to come together to make sure a program like this can run. The patients that would utilize a service like this have not a lot of income so it’s like your providing services for free. But you can have the patients pay small copay for PCP and specialist office visits.
Managed care plans for the uninsured
Aisha Jones
Managed Care and Health Insurance-HEA 205
Professor: Dr. Christine Connolly
January 19, 2013
Abstract This paper is about an article I read about how managed care plans were created for uninsured patients of New Mexico back in 1997. The University of New Mexico Health science center felt that if they created this managed care plan that it would reduce the use of the emergency room and cost of care for the patients. By utilizing preventive care services this would actually decrease the unnecessary use of the emergency room for preventive and non-urgent care.
Managed care plans for the uninsured:
A program like this is very necessary in areas of which many people have no health coverage at all. When people do not have health coverage they tend to go straight to the emergency room for things regular things such as a cold or just to check and make sure they are ok. Most emergency rooms cannot deny you from care. When uninsured patients do this they are then billed and never pay the hospital they lose out on money for services that they had to provide. Repeated use of the emergency room becomes costly to any hospital. With a managed care plan in place for the uninsured they would be able to utilize the plan for preventive care and urgent care. Studies show that when patients have access to preventive care the will be less likely to go to the emergency room for services that they can just go to their primary care physician for. I think they would come out a lot cheaper having a plan like this where everyone can receive the proper health care service they need. This takes a lot of planning and budgeting of the state/county and the facility to come together to make sure a program like this can run. The patients that would utilize a service like this have not a lot of income so it’s like your providing services for free. But you can have the patients pay small copay for PCP and specialist office visits.
References: Academic Medicine: April 2000 - Volume 75 - Issue 4 - p 323-330, Institutional Issues: Articles Managed Care for Uninsured Patients at an Academic Health Center: A Case Study Kaufman, Arthur MD; Derksen, Daniel MD; McKernan, Stephen; Galbraith, Pamela RN; Sava, Saverio MD; Wills, John MD; Fingado, Elizabeth