managed healthcare

managed healthcare

A comparison of the Affordable Care Act Managed Care and the Traditional U.S. Health Services Delivery System





Managed Care against traditional health services
There are various differences between Affordable Care Act Managed and the Traditional United States’ Healthcare service delivery system. In the current society, almost all healthcare services have adopted Managed Care. Traditional U.S healthcare service delivery system is currently outdated. In the traditional system, or cases where the patients for the service, in this case the patients had opportunity to choose their physicians, made payments and then refunded by their insurance companies for the entire amount spent.
Under the Affordable Car Act or Managed care Act, the different HMOs and PPOs, the insurance companies or medical centres pay hospitals for the expenses of its members. Under the managed Act, doctors may be paid a specific yearly amount no matter how many times the patient seeks or visits the healthcare. This plans helps the insurance companies not to be levied a lot of fee.
Shi and Douglas 2011 explains that under the traditional healthcare system, the four fundamental healthcare delivery functions were fragmented. This means, the insurance company, or the funders had various entities, but some are exceptions. America changed to managed healthcare service in 1990 when the country underwent a tighter integration of the fundamental elements through managed healthcare.
In the tradition system, Shi and Douglas 2011 affirms that fragmentation of the functions meant there was deficiency in controlling its utilization and payments. The amount of healthcare services used referred to as health service utilization. Formerly, the amount of money spent and utilization of health care services was left to the persona and their doctors.
The main of managed healthcare service was to help in achieving the effectiveness through the...

Similar Essays