Managed Health Care :- Integration of both financing and delivery of the health care, within a health plan, that seeks to manage accessibility, cost and quality of care.
Earlier health plans were provider based.
Pre-paid care means you pay a fixed amount per month irrespective of how frequently you visit the physician. If you are healthy in this duration, you are loosing small amount of money but if you are quite sick then you can avail the health care quite cheap. The benefit of physician is fixed sum per month. Blue cross & Blue shield were again pre-paid health plans.
HMO act 1973 provided federal grants and loans for formation HMO. It set-up initial standards for HMO and make it easy to set-up HMOs in states which were not allowing HMO formation. This was considered as key step for managed care health plans.
We will talk more about HMO, POS, PPO and consumer directed health plans in next slides
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