Managed Medical Care and Managed Care Programs Essay

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When it comes to medical care, it is necessary to give special consideration to the fact that proper coordination of care provided by different specialists can help to significantly increase the number of patients reporting improvement in their health and reduced the influence of unwanted symptoms on their daily activities (Tootelian, Mikhailitchenko, Holst, & Gaedeke, 2016). Even though this assumption seems to be applicable to different spheres related to public health services, there is an opinion that the potential for HMO success tends to be different for these spheres. Speaking about the situation with medicine and dentistry, I suppose that HMO system is much more likely to improve the situation in the field of medicine even though it could be important for patients with dental problems as well. To begin with, discussing the potential for HMO success in medicine and dentistry it is important to mention that this management system cannot provide the opportunity to reduce the costs of dental services. More than that, health care benefits in this sphere also remain unavailable for patients and it significantly reduces the potential of the system in connection with dentistry. Also, when it comes to dental care, it is important to realize that patients with dental problems are not supposed to receive care from a range of specialists, they just need to visit one dentist to receive consultation or treatment. In fact, the attempt to design the system and apply its principles to two spheres of healthcare that cannot be compared to each other seems to lead to the narrow-vision development, and this is why the results of HMO in medicine and dentistry are so different.

Different managed care programs used in the United States are supposed to provide citizens with easier access to health care programs allowing them to receive services of high quality. If I were a patient suffering from dental problems, I would prefer to use the PPO plan due to the numerous advantages that it involves. To begin with, I would choose it because such type of coverage can be called relatively inexpensive but it cannot be said that the price has a negative influence on the quality of services provided. PPO remains the system that does not require a lot of money. For instance, if we speak about a range of obligatory payments (such as copayment made during the appointment), it is necessary to say that they are not used in the PPO plan and this fact can be regarded as an additional reason to tilt toward this type of coverage (Kosteas & Renna, 2014). Apart from that, choosing the most appropriate plan, it is extremely important to take into consideration not only your current financial position but also your own preferences when it comes to the choice of specialist. When it comes to HMO plans that are extremely popular, they provide people with the right to choose one specialist who will control health care services they will receive. Unfortunately, there is no opportunity for patients to visit another specialist without receiving appointment cards from their physicians. In case with PPO plans, patients can visit not only those health care providers belonging to their network but also those specialists from other networks. As a patient, I would appreciate being given the right to choose specialists and health care providers myself. Nevertheless, if patients with PPO plans choose providers outside their network, their payments will increase.

References

Kosteas, V. D., & Renna, F. (2014). Plan choice, health insurance cost and premium sharing. Journal of Health Economics, 35(1), 179-188.

Tootelian, D. H., Mikhailitchenko, A., Holst, C., & Gaedeke, R. M. (2016). How much segmentation is needed in the health care marketplace? An exploratory study of HMO and non-HMO customers. Health Marketing Quarterly, 33(1), 31-47.

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IvyPanda. (2022, September 18). Managed Medical Care and Managed Care Programs. https://ivypanda.com/essays/managed-medical-care-and-managed-care-programs/

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IvyPanda. (2022) 'Managed Medical Care and Managed Care Programs'. 18 September.

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IvyPanda. 2022. "Managed Medical Care and Managed Care Programs." September 18, 2022. https://ivypanda.com/essays/managed-medical-care-and-managed-care-programs/.

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IvyPanda. "Managed Medical Care and Managed Care Programs." September 18, 2022. https://ivypanda.com/essays/managed-medical-care-and-managed-care-programs/.

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