Preview

Should Medicaid and Hmos Be Allowed to Join Forces

Good Essays
Open Document
Open Document
307 Words
Grammar
Grammar
Plagiarism
Plagiarism
Writing
Writing
Score
Score
Should Medicaid and Hmos Be Allowed to Join Forces
Medicaid And HMOs Video

Juliet mikeworth

Pros and cons

7/21/13

Should Medicaid and medicare be allowed to join forces

First of all what is the definition of cost efficiency and quality or improvement quality?

This is mainly looked at the cost per unit of output, when it comes to health care then one must measure the cost, I believe that to have an efficient Medicaid program we must have one that has better outcome for a given level of spending, it must be assessed by comparing spending and also the outcome of Medicaid programs .

Hmos has the most restrictive form of health insuarance, whereby they restrict their subscribers choices to doctors and hospital in their networks,I think if the hmos join forces it would help if at first they are given choices of at least two or three hmos to choose from ,in return this should help Medicaid /medicare patient s have a choice of choosing their provider .

Alot of states have contractwithprivate insurers to enroll medicaind recipients in managed care plans, this is to help reduce the expenses and also trying to the coordination care.

From different website I found out that Medicaid hmo provide solidhealthcoverage, some have motivated Medicaid plans,which in return improve the care,butin reality majority ofmedicaid HMOs do not report comprehensive performance results that tends to be campaired accress the country in return this leaves the tax payers with a lack of objectives.

I think what the plans need to do is to start planning and also reporting thoroughly so as to pay a the consummers and taxpayers better.

I still believe that the physicians are participating less and less when it comes to mandatory HMO program for Medicaid beneficiaries,

As we know traditional medicare HMO are very similar to the medicare managed care that exsisted

You May Also Find These Documents Helpful

  • Good Essays

    Hcr 230 Week 1 Assignment

    • 473 Words
    • 2 Pages

    With HMO plans there is a list of providers that the patient can only go to, if they go to a doctor that is not in the list of providers they will have to pay extra. The only way that a patient should see a provider out of the network is if it is an emergency. HMO’s have an annual premium and a copayment that is due at the time of service. The main services the HMO’s cover is preventive and wellness checks and disease management. However, in order for complete coverage the enrollees must see a doctor that offers an HMO plan. The providers manage the care and referrals are required, low payments, ad this plan does cover preventative care.…

    • 473 Words
    • 2 Pages
    Good Essays
  • Good Essays

    You Decide

    • 1119 Words
    • 5 Pages

    HMO which stands for Health Maintenance Organizations are licensed health plans that place providers, as well as the health plans, with dealing with HMO’s there is a risk of medical expenses. The downfall with HMO is that patients must stay inside their network and if the go outside the network they will have to pay out of pocket expenses. HMO is very limited; many patients don’t like limitations when it comes to their decision about their health.…

    • 1119 Words
    • 5 Pages
    Good Essays
  • Better Essays

    The purpose of a managed care organization is to coordinate the costs and delivery of health care. A managed care organization oversees money spent on labor, technology, and facilities such as physician offices and hospitals. A type of managed care organization is a Health Maintenance Organization (HMO). A HMO “provides medical care for all its enrollees in return for a fixed annual fee per enrollee” (University of Phoenix, 2010, Key Terms and Concepts Section). An HMO tightly oversees the use of health care services thereby reducing costs and controlling utilization. For example, HMO’s…

    • 1187 Words
    • 5 Pages
    Better Essays
  • Satisfactory Essays

    Specific Medicare depends on their company. I that essence, the members may be required to pay higher out of pocket costs. This is different to the original Medicare. In such a case, the member of the Medicare will have no benefit in the use of the health coverage but loses. In that essence, there is no need of having either Medicare or Medicaid health human services reimbursement. These services should be considerate and willingly to help the poor without changing their plans and benefits annually.…

    • 443 Words
    • 2 Pages
    Satisfactory Essays
  • Good Essays

    The similarities is that most medical offices compared to hospitals or governmental entities accept most insurances. Funding is primarily from insurance companies, private sources, and self-pay. Some private practices more acceptable to Medicare than Medicaid but maintain a heavy volume of patient care in each setting.…

    • 444 Words
    • 2 Pages
    Good Essays
  • Satisfactory Essays

    There are several ways the managed care model is expressed one particular way is the Health Maintenance Organization or better known as HMO. HMOs have their own network of doctors, hospitals and other health care providers who have agreed to accept a payment plan at a certain level of services they provide. With HMO, you would have to pick a Primary Care Physician within the local approved network where that doctor can coordinate any additional care you might need. If you need a specialist, a referral would be needed within the HMO network. HMOs usually have lower monthly premiums, but out of network health care professionals are not typically covered by the insurance.…

    • 394 Words
    • 2 Pages
    Satisfactory Essays
  • Satisfactory Essays

    Observing from my classmates I have learned from them that there are six types of managed care models. There are the health maintenance organizations (HMOs), the preferred provider organizations (PPOs), exclusive provider organizations (EPOs), physician hospital organizations (PHOs), point-of-service (POS) plans, and provider-sponsored organizations…

    • 290 Words
    • 2 Pages
    Satisfactory Essays
  • Satisfactory Essays

    Difference and Plan

    • 345 Words
    • 2 Pages

    These health plans have a lot of similarities and differences. Some of the similarities are the majority of these plans have low copayments, and very close coverage. The HMO and POS plans have lower copayments than some of the other plans and these plans cover the total cost of preventative care. Some of the plans allow you to go out of network and the other plans will not pay or cover unless it is in the network.…

    • 345 Words
    • 2 Pages
    Satisfactory Essays
  • Good Essays

    Obama Care Pros and Cons

    • 2915 Words
    • 12 Pages

    Some Medicare payments to doctors and hospitals have been limited. (Medicare pays doctors more than any other type of coverage and…

    • 2915 Words
    • 12 Pages
    Good Essays
  • Good Essays

    Managed care has been formed since the 1930 and evolved over the last ten years. Since the evolving of managed care there are three types of managed care plans. People that are enrolled in private health insurance are subscribed to a type of managed care plan. There are many differences between the three types of managed care plans and they also have similarities. The involvement of managed care plans are between the insurer and the selected network of health care providers, and the policyholder’s financial incentive that are used by the providers in the network. There are precise measures for choosing a managed care plan and conventional procedures to acquire quality care (Types of Insurance, 2010).…

    • 686 Words
    • 3 Pages
    Good Essays
  • Better Essays

    Evolution of Managed Care

    • 1519 Words
    • 7 Pages

    References: Davis, K., Collins, K., & Morris, C. (2006). Managed Care: Promise and Concerns. Retrieved on August 25, 2010, from http://content.healthaffairs.org/cgi/reprint/13/4/178.pdf…

    • 1519 Words
    • 7 Pages
    Better Essays
  • Good Essays

    Although people link Medicare and Medicaid; Medicaid is entirely different. Medicaid is also a federally funded insurance program however this program serves low-income and underprivileged populations. Although Medicaid is federally funded, funds are allocated and distributed by the state. The state is mandated to facilitate programs for Medicaid; additionally, the state determines the eligibility of Medicaid recipients, the type of service received, the duration, and the scope of service. The state also regulates payments for services.…

    • 104 Words
    • 1 Page
    Good Essays
  • Good Essays

    The difference between the two includes the size of the network, ability to see specialist, plan cost, and coverage for out-of- network services. (“PPO VS HMO: What is the difference?). The HMO is more affordable and allows you to choose a doctor or the insurance assigns a doctor that is in your network at a cost dictated by the insurance. This usually lowers or eliminates the deductibles. However, the PPO plan is more flexible and consumers get to choose the doctor and the hospital even if it is not in network at a rate above what the insurance will pay. The patient is usually responsible for out of network cost and…

    • 882 Words
    • 4 Pages
    Good Essays
  • Good Essays

    Medicaid Expansion

    • 886 Words
    • 4 Pages

    In 2009 there were 50.7 million people, 16.7% of the population, without health insurance. Americans all over the country are working and yet they still can’t afford to pay the high cost of health insurance for themselves and their families. Under the Affordable Care Act of 2010, which was signed by Obama on March 23, 2010, thirty two million Americans who were previously not eligible for Medicaid may now have the opportunity to be covered. If this act is passed in North Carolina then it will be expanded to cover nearly all of the 1.5 million North Carolinians who are without health insurance. If more Americans are covered under the Medicaid that they need then they will be able to go to the doctors when they get sick, or go to the hospital if they have an accident and not have to deal with the stress of wondering how they will pay for it. I believe that Medicaid should be expanded in North Carolina and every state, to the many Americans who are without health insurance to insure that they live healthy lives.…

    • 886 Words
    • 4 Pages
    Good Essays
  • Best Essays

    NC Medicaid Expansion

    • 3543 Words
    • 15 Pages

    As servants of the people of North Carolina, government has the responsibility to work in the best interests of the its residents. After careful research and consideration, the conclusion has been drawn the expanding Medicare eligibility, under the guidelines associated with the 2010 Affordable Care Act (ACA), would best meet that interest. This conclusion was based on four factors and determinations listed below:…

    • 3543 Words
    • 15 Pages
    Best Essays

Related Topics