Checkpoint Features of Health Plans

Checkpoint Features of Health Plans - doctors in their...

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Checkpoint: Features of Health Plans Adrienne Martin HCR/220 Ms. Tucker
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There have been Managed Health Care programs in one way or another since the 1930’s but they have only become a vast majority over the past ten years. As these plans grew they gave patients three main options in health plans. PPO’s (Preferred Provider Organizations), which gave their patients a lower fee to see the doctors within their plan but also the freedom to go outside of the network. POS (Point of Service), these plans also give the patient freedom to see other doctors but a Primary Care Physician must be chosen from within their network and referrals to other doctors or specialists is often difficult and costly. POS plans also cover many preventive care services within their network such as health and nutrition classes and help to quit smoking. HMO’s (Health Maintenance Organizations) , these programs require that a patient only see
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Unformatted text preview: doctors in their network and that referral to a spet must be done by the patients Primary care Physician. In some cases a patient may even need to get approval to visit an emergency room. It is my opinion that HMO’s give the best benefit to the provider since patients are confined to providers within the network of the plan. A patient pays a set fee for coverage and is only able to use this plans hospitals and care facilities. A PPO can be more beneficial to the patient due to the fact that there are not any restrictions on doctors or health care facilities and a patient also has the choice to be seen by doctors within the plan which will save them money. References: Agency for Healthcare Research and Quality,
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