Wednesday, May 29, 2019

student :: essays research papers fc

I believe managed cargon plans do not take into account coverage for the necessary duration of infirmary preserves. Most managed care plans, particularly HMOs, are run by for-profit companies. These for-profits are constantly looking for ways to curb costs and increase their market share. Managed care plans settle choice of physicians and health care facilities and tightly control both the utilization of services and the amount supercharged for these services. In many plans, a set fee per person/per month is negotiated between health care purchasers and providers. This rate is the same no matter how some(prenominal) or how little care a person receives. This can encourage incomplete advice and inadequate treatment, as in the case of the duration of a hospital stay. Most hospital procedures and surgeries, both outpatient and inpatient, require prior approval. Most plans may require that certain procedures and surgeries be done on an outpatient basis in enunciate to be paid fo r by the plan. Basically, managed care plans cuts the duration of a hospital stay form the usual post-procedure stay period by discharging them home early. For inpatient hospital care, managed care plans often require prior approval to limit the number of days they will pay for your child to stay in the hospital. coverage for longer stays requires approval by the managed care plan. (Your Managed Care) If longer stay or duration is inevitable in a hospital, you will be needed to require lengthy appeals and numerous referrals. Without such approval, you may be responsible for part or all of the hospital and physician charges, thus effectively trammel the length of hospital stay.Not only are patients being pressured/forced into limiting their duration of stay in a hospital, but lately physicians are also facing pressure from managed care plans to lower costs of treatments to gain a bigger profit margin. For example until 1996, doctors were allowing a new mother to stay for as little in a hospital post pregnancy as dictated by managed care plans, until a federal mandate put up a minimum and gave new mothers at least 48 hours in the hospital. (Wehrwein 1997) Managed care organizations are offering incentives to doctor changes normal procedures and length of stays to limit expense. Procedures that are simpler or require less time, work are done, over more modern better suited for patient procedures. Managed care organizations are principally worried about controlling costs, and they see that having doctors perform procedures and treatments that require the least amount of hospital stay as more efficient.

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