DOCUMENTS

papers

Case study: the Minneapolis Buyers Health Care Action Group

Published: June 1, 1998
Category: Papers
Author: Knutson D
Country: United States
Language: null
Types: Care Management, Finance/Budgeting
Setting: Health Plan

Inquiry 35:171-177.

Health Research Center, Institute for Research and Education, Health System Minnesota, Minneapolis, MN, USA

Managed care plans are a type of health insurance. They have contracts with health care providers and medical facilities to provide care for members at reduced costs. These providers make up the plan’s network. How much of your care the plan will pay for depends on the network’s rules.

Plans that restrict your choices usually cost you less. If you want a flexible plan, it will probably cost more. There are three types of managed care plans:

  • Health Maintenance Organizations (HMO) usually only pay for care within the network. You choose a primary care doctor who coordinates most of your care.
  • Preferred Provider Organizations (PPO) usually pay more if you get care within the network. They still pay part of the cost if you go outside the network.
  • Point of Service (POS) plans let you choose between an HMO or a PPO each time you need care.

PMID: 9719785

United States,Payment,Actuarial Analysis,Economic Competition,Health Care Coalitions,Health Status Indicators,Managed Care Programs/economics,Minnesota,Organizational Care Studies

Please log in/register to access.

Log in/Register

© The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System.
All rights reserved. Terms of Use Privacy Statement

Back to top