Managed Care

Managed Care

The Purpose of an MCO

A managed care organization (MCO) consists of doctors, nurses, other healthcare providers, and healthcare facilities. The objective of this organization is to offer crucial and inexpensive healthcare services (Stadhouders et al., 2019). They provide insured health services in the form of different packages. A person receives healthcare services from various healthcare professionals and healthcare facilities depending on the healthcare package they choose. Managed care organizations are made up of a group of healthcare professionals working to reduce the cost of healthcare services. There are four types of managed care organizations: Health Managed Organizations (HMOs), Preferred Provider Organizations (PPOs), Point of Service Organizations (PSOs), and Exclusive Provider Organizations (EPOs) (Chaaban et al., 2018).

Differences between MCOs, HMOs, PPOs, and EPOs, and Ethical Concerns

Health Managed Organizations appoint a specific healthcare facility or healthcare providers to attend to people who have chosen this organization. Cost is only subsidized if the person seeking health services visits the chosen facilities or is attended to by the chosen health professionals. Preferred Provider organizations subsidize the cost of health services offered if a person is provided with services from select healthcare facilities or healthcare professionals. Furthermore, a person can seek health services from healthcare providers that the organization does not choose. However, the cost of seeking services from non-selected health professionals will be higher. Get in touch with us at eminencepapers.com. We offer assignment help with high professionalism.

Exclusive provider organizations give a person the freedom to choose healthcare providers with whom they are comfortable. Nonetheless, the organization does not subsidize costs when the individual seeks treatment from healthcare providers that are not part of the organization. It is unethical to provide monetary incentives to physicians who keep the cost of caring for patients as low as possible. Physicians take an oath to serve patients wholeheartedly without seeking any form of reward. Therefore, they should work whether an incentive has been provided or not.

References

Chaaban, M. R., Rana, N., Baillargeon, J., Baillargeon, G., Resto, V., & Kuo, Y. F. (2018). Outcomes and complications of balloon and conventional functional endoscopic sinus surgery. American Journal of Rhinology & allergy, 32(5), 388-396. https://doi.org/10.1177%2F1945892418782248

Stadhouders, N., Kruse, F., Tanke, M., Koolman, X., & Jeurissen, P. (2019). Effective healthcare cost-containment policies: a systematic review. Health Policy, 123(1), 71-79. https://doi.org/10.1016/j.healthpol.2018.10.015

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The term “managed care” refers to several different forms of healthcare provision intended to ensure quality care for people in America at lower costs. In 1973, the Health Maintenance Organization Act was signed by President Nixon, and funding for HMO expansion was provided to employers willing to provide health insurance for employees. HMOs were the first true form of managed care.

Managed Care

MCOs have gone through many changes over the years, some of which have been beneficial and others that have not been successful.

After a thorough research of credible sources from the South University Online Library and the Internet, please answer the following questions:

What is the purpose of an MCO?
What are the major differences between MCOs, Health Managed Organizations (HMOs), Preferred Provider Organizations (PPOs), and Exclusive Provider Organizations (EPOs)?
MCOs provide monetary incentives to physicians who keep the costs of caring for patients as low as possible. Do you feel it is ethical? Why or why not?
To support your work, use your course and textbook readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.