Pros and Cons of Managed Care

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Pros and Cons of Managed Care
Some of the pros for managed care are; Preventive care — HMOs pay for programs, they are set up and are intended at keeping one healthy (yearly checkups, gym memberships, etc.)The idea is, so they won't have to pay for more costly services when and if one gets sick. Lower premiums — Because there are limits set as to which doctors one can see and when one can see them, HMOs charge a premium and usually they are lower premiums. Prescriptions — As part of their precautionary retreat, most prescriptions are covered by HMOs for a co-payment that also can be very low. Fewer unnecessary procedures —doctors are given financial incentives from HMOs , to provide only needed care, so doctors are less likely to order costly test or surgeries that one does not need. Limited paperwork — While healthcare professionals and facilities have more paperwork, under managed care, HMO members usually only has to show their membership card and pay a very low co-payment. Some of the cons for managed are; Limited doctor groups — To keep financial burdens down, HMOs tell one which doctors’ one can see, including specialized fields. Restricted coverage — one cannot expect care on command because ones primary-care physician must justify the need based on what benefits ones plan covers. Prior approval needed — If one would like to see a specialized doctor or go to the emergency room, one would need permission from their main physician. Possibility of under treatment — Because of the incentives given doctors to limit care, the doctor may try to hold back on good care management he would give. Compromised privacy — HMOs use patient records to keep an eye on doctors' performance and efficiency, so particulars of one’s medical history could be seen by other people.

Getting medical care used to be thought of as trouble-free. One would go to the physician of their choice, get great care and their health insurance would cover the cost of seeing the...
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