Managed Care Organizations

  • FAST HOMEWORK HELP
  • HELP FROM TOP TUTORS
  • ZERO PLAGIARISM
  • NO AI USED
  • SECURE PAYMENT SYSTEM
  • PRIVACY GUARANTEED
Appendix
   Population servedSource of FundsWho controls itProsCons
Managed Care PlansThe managed care organization(MCO)is a group of healthcare providers that provide managed care healthcare plans. It serves both the Medicare and MedicaidGeneral Taxes, Employer-based and from monthly premium, federal funded program  Federal governmentReduces the cost of healthcare for individuals who have enrolled to it People can access care within their network Information is passed effectively and efficiently in the network very quickly The process is made easier due to prescription management  There is the limitation of care for an individual with no insurance or provider coverage Individuals have to advocate for themselves Have stringent rules Risk to loss of privacy In case a network is busy, people have to wait for a long time
MedicaidMedicaid is a  state and federal program that provides health coverage for individuals with a meager income.Federal Medical Assistance Percentage (FMAP)Federal government and stateThe program focuses on elderly individuals and those suffering from disabilities The copay cost of their patient is usually lower and a lot more affordable It gives a guarantee of financial protection as most medical care expenses are catered for The individual enrolled in this program are entitled to receive care using privately managed plans  Not everyone with low income qualifies to be enrolled in the Medicaid program In case of emergency, the patient may be vulnerable to low-quality care since they are under Medicaid Discrimination is an issue that affects those enrolled in this program
MedicareMedicare program is a program under the federal government that offers healthcare coverage for individuals aged 65 and above years or those under 65 but living with disability despite their incomePremiums, payrolls, self-employment taxes, trust funds, and money authorized by the governmentFederal governmentThe program provides coverage for a large population Have a Medicare Advantage plan that offers additional coverage The cost at Medicare is generally low   The Medicare cost comes from taxpayers Being admitted to the hospital raises the cost of Medicare The cost in Medicare are usually high to administrate
Table 1 Comparison of Managed Care Plans, Medicare, and Medicaid
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