Getting to the point of service; to satisfy consumers' demands for health care cost controls and flexibility, insurers must integrate indemnity and managed care products into point-of-service plans
Article Abstract:
Health insurers can be more competitive by integrating indemnity and managed care products into point-of-service (POS) programs. These programs, combining preferred provider programs with health maintenance organizations, link quality with cost control. POS program benefits are at least 20% lower for out-of-network service to encourage use of managed care. A well-designed POS program also includes financial incentives for providers to deliver quality care while controlling costs.
Publication Name: Best's Review Life-Health Insurance Edition
Subject: Insurance
ISSN: 0275-0988
Year: 1992
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A question of commitment: before committing capital to the group health business, insurers should differentiate local market strategies to help decide where they want to compete. Then, they can invest in some markets and exit others
Article Abstract:
The group insurance business is entering the downside of the underwriting cycle and requires an infusion of capital to solidify its managed care position. In the 1990s, the emphasis will be not just on managed care, but also on managed costs. However, the return on additional investments will likely be less than the 0.3% earned over the last business cycle. CEOs must evaluate whether they can afford to stay in the group market. If so, local market strategies must be developed.
Publication Name: Best's Review Life-Health Insurance Edition
Subject: Insurance
ISSN: 0275-0988
Year: 1992
User Contributions:
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Now is the time; competitive pressures and other factors in the current environment make it imperative that insurers act now to establish or improve their provider networks
Article Abstract:
Health insurers that offer managed care plans must establish relationships with healthcare providers or networks to be competitive in the 1990s. Provider choice within such a plan is a popular option. However, choice can be expensive when out-of-network providers are selected. Expanding provider networks assures cost and access will be predictable. Instructions on how to directly contract with providers while maintaining quality standards are provided.
Publication Name: Best's Review Life-Health Insurance Edition
Subject: Insurance
ISSN: 0275-0988
Year: 1992
User Contributions:
Comment about this article or add new information about this topic:
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