US Health Care System: Week 5  For this assignment, you will generate, designate, Organize, investigate and, present a Manage Care Control Cost Plan: Under traditional indemnity insurance, the money follows the patient. Patients select health care providers and visit them as they choose. Providers then bill the private insurer or public payer and are reimbursed on a fee-for-service or per case basis  Manage Care Control Cost Plan: Chapters 9 & 10 Objective : Managed health care as it has developed in the USA, and the current backlash against it, must be viewed in the context of the traditional US health care system. This system of employer-based, indemnity insurance and fee-for-service health care conditioned both providers ‘and patients ‘expectations of unlimited resources and unrestrained choice.  Not surprisingly, the constraints and controls imposed by managed care have resulted in outrage by doctors and their patients (and by doctors through their patients). ASSIGNMENT GUIDELINES (10%): For this assignment, you will generate, designate, Organize, investigate and, present a Manage Care Control Cost Plan: Under traditional indemnity insurance, the money follows the patient. Patients select health care providers and visit them as they choose. Providers then bill the private insurer or public payer and are reimbursed on a fee-for-service or per case basis. Most indemnity plans attempt to limit demand through financial barriers to the patient, such as deductibles and co-insurance, rather than constraints on the provider. Many also require the patient to pay the provider directly and seek reimbursement from the insurer, often with payments less than charges.  Due to growing popular discontent with managed care organizations, many critics believe that the system will not continue in its current state. No one, however, expects managed care to disappear completely and indemnity plans to rise to their former prominence. Changes are expected to occur as managed care programs begin competing among themselves. Cost and efficiency will no longer be the main selling point; quality of services will take precedence. One researcher has suggested that along with new systems of managed care and continuing systems of indemnity plans, health care providers may even organize and offer services directly to employers, thus eliminating the middlemen. This development would be beneficial to all involved: employers would pay less; providers would be better compensated; and clients would receive better care The paper will be 4-5 pages long. More information and due date will provide in the Fifth Week assignments link. EACH PAPER SHOULD INCLUDE THE   FOLLOWING: 1. Introduction (30%) Provide a short-lived outline of the meaning (not a description) of Chapter 9 and 10 and articles you read, in your own words. Types and classifications of managed care models. 2. Manage Care Control Cost Plan: (50%) a. Cost savings ‘‘Structural changes centere ...

1. US Health Care System:
Week 5
For this assignment, you will generate, designate, Organize,
investigate and, present a Manage Care Control Cost Plan:
Under traditional indemnity insurance, the money follows the
patient. Patients select health care providers and visit them as
they choose. Providers then bill the private insurer or public
payer and are reimbursed on a fee-for-service or per case basis
Manage Care Control Cost Plan: Chapters 9 & 10
Objective
:
Managed health care as it has developed in the USA, and the
current backlash against it, must be viewed in the context of the
traditional US health care system.
This system of employer-based, indemnity insurance and fee-
for-service health care conditioned both providers ‘and patients
‘expectations of unlimited resources and unrestrained choice.
Not surprisingly, the constraints and controls imposed by
managed care have resulted in outrage by doctors and their
patients (and by doctors through their patients).
ASSIGNMENT GUIDELINES (10%):
For this assignment, you will generate, designate, Organize,
investigate and, present a Manage Care Control Cost Plan:
Under traditional indemnity insurance, the money follows the
patient. Patients select health care providers and visit them as

2. they choose. Providers then bill the private insurer or public
payer and are reimbursed on a fee-for-service or per case basis.
Most indemnity plans attempt to limit demand through financial
barriers to the patient, such as deductibles and co-insurance,
rather than constraints on the provider. Many also require the
patient to pay the provider directly and seek reimbursement
from the insurer, often with payments less than charges.
Due to growing popular discontent with managed care
organizations, many critics believe that the system will not
continue in its current state. No one, however, expects managed
care to disappear completely and indemnity plans to rise to their
former prominence. Changes are expected to occur as managed
care programs begin competing among themselves. Cost and
efficiency will no longer be the main selling point; quality of
services will take precedence. One researcher has suggested that
along with new systems of managed care and continuing
systems of indemnity plans, health care providers may even
organize and offer services directly to employers, thus
eliminating the middlemen. This development would be
beneficial to all involved: employers would pay less; providers
would be better compensated; and clients would receive better
care
The paper will be 4-5 pages long. More information and due
date will provide in the Fifth Week assignments link.
EACH PAPER SHOULD INCLUDE THE FOLLOWING:
1.
Introduction (30%)
Provide a short-lived outline of the meaning (not a description)
of Chapter 9 and 10 and articles you read, in your own words.

3. Types and classifications of managed care models.
2.
Manage Care Control Cost Plan:
(50%)
a.
Cost savings
‘‘Structural changes centered around the expansion of managed
care have been the major transformative force in health markets
in recent years and have played a major role in restraining
growth in health spending’’
b. Provider reimbursement
This complaint has two dimensions: hospital profitability, and
physician compensation. As far as hospitals are concerned,
administrators are worried about profitability or surplus for
reinvestment, and consumers are worried about the threat of
hospital closures. Few things stir as much public outcry as the
prospect of closing a community hospital.
c. Quality of care
Much recent legislation and many legal reforms have been
aimed at preventing managed care’s perceived quality abuses.
The Patient Bill of Rights, which has been heavily debated in
Congress, defines, among other things, the rights of consumers
with complex conditions to access directly a qualified
specialist, continuity of provider for patients who are under
regular treatment, and self-referral to certain types of
specialists.

4. 3.
Conclusion (20%)
Quickly recapitulate your thoughts & statement to your critique
of the articles and Chapter you read. How did these articles and
Chapters impact your thoughts about Manage Care? What did
you learn about manage care and how you will apply all these
knowledge?
Evaluation will be based on how clearly you respond to the
above, in particular:
a) The precision with which you analyses the articles;
b) The complexity, possibility, and organization of your paper;
and,
c) Your conclusions, including a description of the impact of
these articles and Chapters on any Health Care Setting.
ASSIGNMENT DUE DATE:
The assignment is to be electronically posted no later than noon
on Friday, April 5, 2019.