How managed care works

Article Abstract:

An overview of the development of the managed health care industry reveals that it is possible to show how managed health care has been successful in moderating and restraining health care spending. Two common elements of the managed care industry are preferred provider organizations (PPOs) and health maintenance organizations (HMOs). PPOs were developed to deliver services at discounted prices, while HMOs were developed to provide all health services in one organization. The managed care industry has served as the catalyst for various changes in the health care industry such as: shifting focus on home care and physician reimbursement; helping states to stress health care delivery reform; and helping health care providers realize that management is fundamental to cost control. Utilizing managed care programs have significantly increased savings for employers such as: General Motors, Xerox Corp and Sun Co.

Managed care plans (Medical care), Health maintenance organizations, Preferred provider organizations (Medical care)

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Misuse puts flexible benefits at risk

Article Abstract:

An analysis of changes in the Internal Revenue Code regarding flexible benefits for employees reveals that misuse may put flexible benefits at risk if employers do not comply completely. Personnel managers in charge of administering flexible benefits plans need to be particularly aware of the factors affecting such things as: advance/accrual reimbursement plans; demand reimbursements; and non-discrimination testing. Suggestions are given to ensure effective administration including: using a quality administration system; having experienced attorneys review all documentation; and demanding to see complete discrimination testing.

Cafeteria benefit plans

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