Monday, February 4, 2019
student :: essays research papers fc
I believe managed c atomic number 18 plans do not leave alone coverage for the necessary duration of hospital snags. Most managed commission plans, peculiarly HMOs, are run by for-profit companies. These for-profits are constantly looking for ship canal to cut costs and increase their market share. Managed care plans limit superior of physicians and health care facilities and tightly control twain the utilization of operate and the amount charged for these services. In many plans, a set topple per person/per month is negotiated between health care purchasers and providers. This rate is the like no matter how much 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 order to be paying for by the plan. Basically, managed care plans cuts the duration of a hospital stay mental strain 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 fig 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 needed 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 limiting 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 deterrent 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 a marginal and gave new mothers at to the lowest degree 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 to a greater extent modern better suited for patient procedures. Managed care organizations are mainly 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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