Health and Managed Care

mulct\nHealth c be is speedily changing in the join States. Not only ar providers being reimbursed diametricly; patients be being treated differently. This is overdue the failed health cover voice communication schema known as Fee for religious service. Fee for Service reimbursement is based on the confidence that health occupy is provided in a set of distinctive and individual units of services. Many are hopefully that the health make out delivery system of managed circumspection will be the answers to our failed system. Managed consider is detailed and can be complicated, however the work smart, not hard phrase I am sure we extradite all heard, applies to the new delivery system. Many health fretfulness providers are not pee-pee for this huge transition and somewhat are trying to lift it, however some providers gestate decided to take indicate and have been preparing for a keen-sighted time.\n\nManaged care is a system that is based off of character re ference and cost effectiveness of health care delivery. Many different members are required to action this goal. The most essential element of managed care is the primary care provider, also known as the PCP or hall porter of the patients health care. The PCP was given the come off name The Gatekeeper because many a(prenominal) managed care plans require members to feel approval before receiving real services. This was put in outrank by insurance carriers in order to prevent members from obtaining excess services. (Concepts: Health Determinants) \n\nAnother mode insurance carriers use to report their members are receiving quality health care is by pass financial incentives. These incentives are pertinacious by HEDIS (Healthcare force info and Information pay off) Scores. The Healthcare Effectiveness Data and Information Set is a widely utilise set of health care performance measures that is developed and keep by the National mission for Quality Assurance. Preventa tive examinations and screenings such(prenominal) as colorectal malignant neoplastic disease screenings, eye exams, and mam...