Managed Care Term Paper

1457 Words Apr 26th, 2013 6 Pages
U.S. Health Care Delivery System
Term Paper
Margarita Blanco
March.29th, 2010

Managed care was started as early as the 1900’s, the cited pioneer of the structured system of care that is known today as “Managed Care” is Dr. Michael Shadid. His goal was to help meet the health care needs of a certain groups of people. Such as: rural residents, workers and families in the lumber, mining and railroad industries; the enrollees paid a set fee to physicians who then delivered care under the terms of their agreement. By 1929 the Los Angeles department of water and power contracted with Drs Ronald Ross and H. Clifford Loos to provide service for almost 2,000
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If you choose to go outside of your network for health care you will get charge a deductible like a PPO plan, charges will be about 300 dollars for and individual or 600 dollars for a family. For some reason when I was researching managed care majority of the websites I came across never mentioned Exclusive Provider Organization [EPO] then I finally came across it. Exclusive Provider Organization [EPO] is the type of managed care that if you get healthcare outside of your network you will have to pay for it out of pocket, so its not like a Point of Service where you’ll get charged a deductible or a percentage in this case your on your own. Being that EPO member are restricted to in network doctors they are able to negotiate prices. EPO does charge co payments each visit that ranges from 20-30$ and charge a monthly premiums and deductibles. I chose to save the best for last; I will be talking briefly about Health Maintenance Organization [HMO] as well as its advantages and disadvantages. I chose HMO because it was the first form of Managed Care. The earliest from of HMOs can be seen in a number of prepaid health plans tracing back to 1910 the western clinic in Tahoma, Washington offered lumber mills owners and their employees certain medical services from is providers for a premium of 50 cents. However; the first HMO considered in the United States was the Ross-Loss Medical Group in 1929 as I said earlier.
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