Investigate Strengths and Weaknesses of Local Managed Care Systems
There are different types of managed care plans. Two of the most common types are Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs). Most others are hybrids of the two. The basic functions of governance and control in HMOs, PPOs, and other managed care plans are similar to those in any business except the responsibilities vary greatly from one plan to another.
Managed care programs use several functions to control costs: use of a provider network with discounts, prior approval of procedures, utilization management of treatment guidelines, utilization review, case management, peer review and second opinions, prospective, concurrent, and retrospective audits, and grievance procedures.
Week 2 Assignment: Investigate Strengths and Weaknesses of Local Managed Care Systems
“Order a similar paper and get 15% discount on your first order with us Use the following coupon “FIRST15”