Quality Of Indemnity Vs. Managed Care Insurance System

3734 words - 15 pages

INDEMNITY INSURANCE SYSTEM VERSUS THE MANAGED CARE SYSTEM

2005

Table of Contents

Abstract
Introduction
Body
1 General Information about Healthcare systems
2 Types of Plans
2.1 Indemnity
2.2 Managed Care
2.2.1 Health Maintenance Organizations
2.2.2 Preferred Provider Organization
2.2.3 Point of Service
2.2.4 Table 1

3.3 Wellness Programs

3.4 Influences of managed care system on:

3.4.1 Institutions

3.4.2 Customers

3.5 Benefits of indemnity insurance

3.6 Managed care and Quality

3.6.1 Quality Indicators

7 Recommended Changes
8 The role of healthcare managers

3.8.1 Healthcare managers within the providers¡¦ institutions

3.8.2 Healthcare managers within the companies

Conclusion
References

Abstract

People have to face it today that it is impossible to avoid healthcare and therefore some kind of health insurance needs to be chosen. The costs of medical care and treatment are rising every year, and uninsured individuals live with the high risk of facing huge expenses because of emergencies and life-threatening illnesses. However, before choosing the insurance company, customers need to be aware of the various types of private health insurances that are available at the market. For a long time indemnity insurance has been quite popular, nevertheless, with in response to the developments in quality field new healthcare systems such as managed care started to appear. The question which one provides better quality and higher efficiency became even more important to the customers than the issue of expenses. Which system is better regarding quality and efficiency? The following report examined the benefits provided by both systems in order to identify which one is better including the influence of the recent changes in healthcare on medical institutions and customers themselves. The final part of the paper provides some solutions on what can be improved in the policies as well as the involvement of healthcare manager in this process.

Introduction

Health insurance plans can be divided into two major large categories which are indemnity (or reimbursement) plans and managed care plans. Each category has its own benefits as well as disadvantages. Which one is better: traditional indemnity insurance or innovative managed care insurance? Recent researches provide enough information to claim that in general managed care plans are better suited for the average person because in the long term they end up being more cost effective as well as with regards to quality of care and efficiency. In comparison, the indemnity plans are more attractive for some because they hit with more of the deductibles and co-payments, therefore placing the caps on the amount of benefits which can be received in the long run.

Conclusion

In conclusion, the healthcare industry is growing quite quickly and new plans may appear in the nearest future. The...

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