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Managed care describes a form of health insurance that relies on a network of physicians and hospitals brought together to provide medical services at a predetermined, reduced cost. Under managed care, medical care is “managed” to meet both quality and cost standards.<\/p>\n
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Managed care differs from the traditional healthcare indemnity insurance that has covered consumers for more than 50 years. Indemnity plans provide coverage for members only when they require physician or hospital services. With managed care, the emphasis includes not just the treatment of illness, but also wellness, detection, and prevention.<\/p>\n
Under most managed care plans, medical services such as well-baby care, immunizations, mammography, other cancer screenings, and physicals are routinely covered. These preventive healthcare services are typically not covered by traditional insurance plans. Managed care is proactive – instead of reactive – healthcare.<\/p>\n
Education is a priority. Managed care patients may be offered classes prior to surgical procedures to ease and speed their recovery. Educational opportunities may also include classes on CPR training, prepared childbirth, stress and weight management, smoking cessation, men’s and women’s health issues, allergies, and diabetes.<\/p>\n
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With health services provided in the most appropriate settings, managed care results in decreased hospital admissions, shorter lengths of stay, fewer inpatient procedures, and a reduction in reimbursement per episode of care.<\/p>\n
This means that hospitals have to economize and become more efficient. Nationwide, this has led to the integration of hospitals into larger healthcare delivery systems to share resources and reduce unnecessary duplications of services.<\/p>\n
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[\/et_pb_accordion_item][et_pb_accordion_item title=”Before You Choose a Plan” title_tablet=”Before You Choose a Plan” title_phone=”Before You Choose a Plan” icon_font_size_tablet=”16px” icon_font_size_phone=”16px” _builder_version=”4.17.6″ _module_preset=”default” background_pattern_horizontal_offset=”0px” background_pattern_vertical_offset=”0px” vertical_offset_tablet=”0″ vertical_offset_phone=”0″ horizontal_offset_tablet=”0″ horizontal_offset_phone=”0″ custom_margin=”||||false|false” custom_margin_tablet=”||||false|false” custom_margin_phone=”||||false|false” custom_padding=”||||false|false” custom_padding_tablet=”||||false|false” custom_padding_phone=”||||false|false” background_color_gradient_direction_tablet=”180deg” background_color_gradient_direction_phone=”180deg” background_color_gradient_stops_tablet=”#2b87da 0%|#29c4a9 100%” background_color_gradient_stops_phone=”#2b87da 0%|#29c4a9 100%” background_image_width_tablet=”auto” background_image_width_phone=”auto” background_image_height_tablet=”auto” background_image_height_phone=”auto” background_horizontal_offset_tablet=”0px” background_horizontal_offset_phone=”0px” background_vertical_offset_tablet=”0px” background_vertical_offset_phone=”0px” background_pattern_style_tablet=”polka-dots” background_pattern_style_phone=”polka-dots” background_pattern_width_tablet=”auto” background_pattern_width_phone=”auto” background_pattern_height_tablet=”auto” background_pattern_height_phone=”auto” background_pattern_horizontal_offset_tablet=”0px” background_pattern_horizontal_offset_phone=”0px” background_pattern_vertical_offset_tablet=”0px” background_pattern_vertical_offset_phone=”0px” background_mask_style_tablet=”layer-blob” background_mask_style_phone=”layer-blob” background_mask_width_tablet=”auto” background_mask_width_phone=”auto” background_mask_height_tablet=”auto” background_mask_height_phone=”auto” background_mask_horizontal_offset_tablet=”0px” background_mask_horizontal_offset_phone=”0px” background_mask_vertical_offset_tablet=”0px” background_mask_vertical_offset_phone=”0px” z_index_tablet=”1″ z_index_phone=”1″ hover_transition_duration_tablet=”300ms” hover_transition_duration_phone=”300ms” hover_transition_delay_tablet=”0ms” hover_transition_delay_phone=”0ms” body_text_shadow_horizontal_length_tablet=”0px” body_text_shadow_horizontal_length_phone=”0px” body_text_shadow_vertical_length_tablet=”0px” body_text_shadow_vertical_length_phone=”0px” body_text_shadow_blur_strength_tablet=”1px” body_text_shadow_blur_strength_phone=”1px” body_link_text_shadow_horizontal_length_tablet=”0px” body_link_text_shadow_horizontal_length_phone=”0px” body_link_text_shadow_vertical_length_tablet=”0px” body_link_text_shadow_vertical_length_phone=”0px” body_link_text_shadow_blur_strength_tablet=”1px” body_link_text_shadow_blur_strength_phone=”1px” body_ul_text_shadow_horizontal_length_tablet=”0px” body_ul_text_shadow_horizontal_length_phone=”0px” body_ul_text_shadow_vertical_length_tablet=”0px” body_ul_text_shadow_vertical_length_phone=”0px” body_ul_text_shadow_blur_strength_tablet=”1px” body_ul_text_shadow_blur_strength_phone=”1px” body_ol_text_shadow_horizontal_length_tablet=”0px” body_ol_text_shadow_horizontal_length_phone=”0px” body_ol_text_shadow_vertical_length_tablet=”0px” body_ol_text_shadow_vertical_length_phone=”0px” body_ol_text_shadow_blur_strength_tablet=”1px” body_ol_text_shadow_blur_strength_phone=”1px” body_quote_text_shadow_horizontal_length_tablet=”0px” body_quote_text_shadow_horizontal_length_phone=”0px” body_quote_text_shadow_vertical_length_tablet=”0px” body_quote_text_shadow_vertical_length_phone=”0px” body_quote_text_shadow_blur_strength_tablet=”1px” body_quote_text_shadow_blur_strength_phone=”1px” box_shadow_horizontal_tablet=”0px” box_shadow_horizontal_phone=”0px” box_shadow_vertical_tablet=”0px” box_shadow_vertical_phone=”0px” box_shadow_blur_tablet=”40px” box_shadow_blur_phone=”40px” box_shadow_spread_tablet=”0px” box_shadow_spread_phone=”0px” text_shadow_horizontal_length_tablet=”0px” text_shadow_horizontal_length_phone=”0px” text_shadow_vertical_length_tablet=”0px” text_shadow_vertical_length_phone=”0px” text_shadow_blur_strength_tablet=”1px” text_shadow_blur_strength_phone=”1px” global_colors_info=”{}” toggle_text_shadow_horizontal_length_tablet=”0px” toggle_text_shadow_horizontal_length_phone=”0px” toggle_text_shadow_vertical_length_tablet=”0px” toggle_text_shadow_vertical_length_phone=”0px” toggle_text_shadow_blur_strength_tablet=”1px” toggle_text_shadow_blur_strength_phone=”1px” closed_toggle_text_shadow_horizontal_length_tablet=”0px” closed_toggle_text_shadow_horizontal_length_phone=”0px” closed_toggle_text_shadow_vertical_length_tablet=”0px” closed_toggle_text_shadow_vertical_length_phone=”0px” closed_toggle_text_shadow_blur_strength_tablet=”1px” closed_toggle_text_shadow_blur_strength_phone=”1px” open=”off”]<\/p>\n
Before choosing a plan, ask yourself some key questions to identify the plan that will work best for you and your family:<\/strong><\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”What is a Primary Care Physician (PCP)?” title_tablet=”What is a Primary Care Physician (PCP)?” title_phone=”What is a Primary Care Physician (PCP)?” icon_font_size_tablet=”16px” icon_font_size_phone=”16px” _builder_version=”4.17.6″ _module_preset=”default” background_pattern_horizontal_offset=”0px” background_pattern_vertical_offset=”0px” vertical_offset_tablet=”0″ vertical_offset_phone=”0″ horizontal_offset_tablet=”0″ horizontal_offset_phone=”0″ custom_margin=”||||false|false” custom_margin_tablet=”||||false|false” custom_margin_phone=”||||false|false” custom_padding=”||||false|false” custom_padding_tablet=”||||false|false” custom_padding_phone=”||||false|false” background_color_gradient_direction_tablet=”180deg” background_color_gradient_direction_phone=”180deg” 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box_shadow_horizontal_tablet=”0px” box_shadow_horizontal_phone=”0px” box_shadow_vertical_tablet=”0px” box_shadow_vertical_phone=”0px” box_shadow_blur_tablet=”40px” box_shadow_blur_phone=”40px” box_shadow_spread_tablet=”0px” box_shadow_spread_phone=”0px” text_shadow_horizontal_length_tablet=”0px” text_shadow_horizontal_length_phone=”0px” text_shadow_vertical_length_tablet=”0px” text_shadow_vertical_length_phone=”0px” text_shadow_blur_strength_tablet=”1px” text_shadow_blur_strength_phone=”1px” global_colors_info=”{}” toggle_text_shadow_horizontal_length_tablet=”0px” toggle_text_shadow_horizontal_length_phone=”0px” toggle_text_shadow_vertical_length_tablet=”0px” toggle_text_shadow_vertical_length_phone=”0px” toggle_text_shadow_blur_strength_tablet=”1px” toggle_text_shadow_blur_strength_phone=”1px” closed_toggle_text_shadow_horizontal_length_tablet=”0px” closed_toggle_text_shadow_horizontal_length_phone=”0px” closed_toggle_text_shadow_vertical_length_tablet=”0px” closed_toggle_text_shadow_vertical_length_phone=”0px” closed_toggle_text_shadow_blur_strength_tablet=”1px” closed_toggle_text_shadow_blur_strength_phone=”1px” open=”off”]<\/p>\n Another change under managed care is the rising influence of primary care physicians. Today, your primary care physician – family practitioner, internist, or pediatrician – is assuming the role of “health manager.” He\/she knows your complete medical history and treats the majority of your medical needs. Your primary care physician also guides you when diagnostic procedures and referrals to specialists are needed.<\/p>\n Choice of physicians is an issue in managed care plans. Most managed care plans will furnish you with a list of approved or preferred primary care physicians from which to choose. If your current physician is not on the list, you will need to select a new physician. Some plans allow patients to use physicians who are not preferred providers; however, the patient then pays the difference in cost. Thus, it becomes important to research the network of primary care physicians, specialists, and hospitals that are included in a plan before enrolling.<\/p>\n With managed care, many medical offices are now using physician extenders such as certified nurse-midwives, physician assistants, and nurse practitioners. 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