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The right way to select a managed care company

Article Abstract:

Organizations planning to contract with a managed care provider should first evaluate their specific needs based on factors such as employee base demographics, funding expectations and specific health concerns of the workforce. They should then proceed to choose from at least three providers, using criteria such as multiple network options, service capacities and documented consumer and physician satisfaction data. Organizations that prefer to make a gradual transition to managed care can opt for a point-of-service plan that allows them to go out-of-network.

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State legislative mandates for health benefits

Article Abstract:

A number of legislative mandates are being considered that would require health plans to cover a wider range of specific health benefits. These mandates are typically passed at the state level because of many reasons. Health benefits mandated at the state level do not apply to all types of health plans. A qualitative analysis of the advantages and disadvantages of these state-legislated mandates reveals a number of interesting ethical and economic arguments both for and against the mandates.

Regulation, Licensing, and Inspection of Miscellaneous Commercial Sectors, Insurance Regulation, Laws, regulations and rules, Ethical aspects, Insurance law

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Managed indemnity health insurance

Article Abstract:

Managed indemnity plans, the modified version of indemnity health insurance, guarantee traditional fee-for-service-style medicine under a cost containment setting. Managed indemnity plans, including preffered provider organization, also limit the incentive of physicians to ration care. Emergency room visits and specialist treatment are also offered without greater restrictions under managed indemnity plans, compared to a standard health maintenance organization.

HEALTH SERVICES, Preferred Provider Health Plans, Services, Preferred provider organizations (Medical care)

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