needs; within health care requirements as well as inexpensive keeping in mind that lower cost may not necessarily mean better. With many varieties in health care plans such as Preferred Provider (PPO)‚ Point of Service (POS)‚ and Exclusive Provider Organization (EPO); the Health Maintenance Organization (HMO) is the most preferred and utilized group health insurance plan. As a HMO representative of Castor Insurance‚ health care coverage will be built‚ including the potential utilization of the services
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Accountability Act): The privacy rule‚ which outlines certain entities in a person health plan‚ clearinghouses can disclose or use person health information‚ and who may be allowed to access a patients personal medical records. HMO (Health Maintenance Organization): Is a health management plan that requires patients to have a PCP (primary care physician). A PCP is where patients seek out most of their initial treatment at. If the PCP feels like it is necessary to seek treatment from specialist they will
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Management problems in Healthcare There are many management problems in Health care. There are management problems in every organization‚ but health care sometimes have the biggest management problems of them all‚ because they are dealing with people lives. One of the problems a health care facility can come across is finance. If the patients have no way paying for their treatments than the facility would have to close their doors because they would have no way of paying their employees to
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Consumer-Driven Health Plans Looking for medical health plans can be demanding on time‚ but it is worth the time to look over all the options offered. There are many features to go through from Private Payer Plans‚ such as Preferred Provider Organizations (PPOs)‚ Health Maintenance Organizations (HMOs)‚ Group HMOs‚ Independent Practice Association (IPA)‚ Point of Service (POS)‚ Indemnity Plans‚ and Consumer-Driven Health Plans (CDHP) such as‚ Health Reimbursement Plans‚ and Flexible Savings Accounts‚ (Bayes
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services of high quality at a low price by focusing on prevention‚ health promotion‚ and primary care (Huntington‚ Health care in Chaos: Will We Ever See Real Managed Care?‚ 1997). In these programs‚ groups of doctors‚ hospitals‚ and health care providers join together to provide affordable health insurance to the public (Cohen‚ 2008). Providing preventative care helps keep costs down for insurance companies because it
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found within the organizations (Mancini‚ 2015). For much of the healthcare and nursing staff‚ feelings of fear and loss often accompany an acquisition. The management skills and strategies utilized by those in nursing leadership roles contribute to either the success or failure of the assimilated nursing teams within the organization. Evolution of the Issue In 2005 a prominent health care company based on the east coast with offices around the
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the advances in medical technology. Insurance companies have sought ways to keep the cost of health care down by offering incentives to insured persons to live healthier lifestyles and use less coverage‚ and by making discount arrangements with providers. The government has tried to make health care more accessible and affordable through the Social Security Amendments of 1983‚ the Health Insurance Portability and Accountability Act of 1996 and the current Patient Protection and Affordable Care Act
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reduce health care cost in many ways and have also faced many difficulties along the way. Many Americans years ago did not have health coverage and we are still seeing this today because of the cost of these plans. HMOs or Health Maintenance Organizations are health care plans that reduce health care cost. Members of an HMO are usually required to make a co-payment when seeing a physician. A lot of time members have a deductible they will have to pay before they are able to see their physician too
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for protecting the health of all Americans and for providing essential human services‚ especially to those who are unable to help themselves. Health care in the United States has been an ongoing dispute and a major concern to all involved from the provider to the consumer. The Managed Care Answer Guide is designed to help people
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emergency care Referral for acute and chronic health care conditions Specialized employer services Primary health care services Basic x-ray and lab test The clinic would not only service the local community but also serve as a preferred provider organization (PPO)‚ holding a contractual arrangement with employment groups located near the new clinics area. These services will allow the hospital to expand their referral base‚ increase referrals of privately insured patients and establish a liaison
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