Define, compare and contrast fee-for-service and managed health care plans. What are the similarities and differences? Support your response with one citation and specific examples. Fee for service plans “Fee-for-service plans contain a variety of stipulations designed to control costs and to limit a covered individual’s financial liability” (Martocchio, 2014, p. 147). This agreement is that the consumer pay individually for each aspect of the goods or services receives.
Managed Care plans are also known as prepaid health care plans. Managed healthcare plans strive to deliver high-quality healthcare, while controlling cost. Services and fees are negotiated with healthcare providers and facilities to provide access to otherwise expensive healthcare services to patients. Services under listed within the Managed Care plan monitored continuously to ensure that all services are provided in the most cost effective manner. An HMO or Health Maintenance Organization is an example of a Managed Care Plan.
The primary reason why the managed care model was created to provide satisfactory and best healthcare to all the enrollees at reduced and controlled cost and its aims to ensure that the healthcare provide a suitable medical condition of the patient and safeguarding such services are provided by appropriate provider. Its emphasis on keeping enrollees healthy to reduce use of services. The two types of Managed Care is Preferred Provider Organization (PPO) the other one is Point of Service (POS) plans. The difference with the PPO is that this is not a restricted as the HMO plan and allows people to approach providers outside of the network.
Studies show that manage care that have a higher level of control on patient care it leads to lower medical cost and hospital inflation on cost(Bundorf, Schulman, Stafford, Gaskin, Jollis & Escare, 2004). Also, manage care controls the fees that are paid to physician and manage medical equipment that is provided to the patients (Bundorf, Schulman, Stafford, Gaskin, Jollis & Escare, 2004). The studies show that it is a spillover for manage care and it affects the no managed care patients (Bundorf, Schulman, Stafford, Gaskin, Jollis & Escare, 2004). Most doctors feel that manage care is a positive step for controlling the cost for healthcare. They also, feel that it have a negative impact on medical care (Deom, Agoritsas, Bovier & Perneger, 2010).
In this role, I advised customers on various make up, skincare and fragrance products. I used my expert product knowledge to build a rapport with the customers, and efficiently, accurately and confidently advise customers on their specific needs, ensuring every customer left fully satisfied with their experience. I developed a high level of customer service skills alongside effective communication of information. I worked both individually and alongside a team to maximise sales, exceed targets and build a client base. This role required a high level of motivation and enthusiasm which I successfully brought to CHANEL.
Users of long term care vary in age including young as well as the elderly. Many of these people need help with daily living assistance due to a disability or disease. The elderly may have more than one reason to need assistance. They could suffer from physical disabilities and illness, and have dementia or Alzheimer’s which affects their mental capabilities.
The National Care Standards lay out what all individuals should expect when using care services. They exist to ensure that service users are treated with respect and that human rights are maintained. The new National Care Standards were passed by the government in June 2017 however they will be officially put into practice from April 2018. A Care Standard sets out information on what a good care service should be like and what it should provide for the service user. The National Care Standards include dignity, privacy, choice, safety, realising potential and equality and diversity.
Everyone working in a health and social care setting puts the interest of everyone, who uses the service first Everyone has a duty of care and has the right to expect, support and care in a safe way, minimising any risk. In Health and Social Care settings ‘A duty of care’ is a very common phrase heard.
The continuum of care is a range of programs of health care services broken down into three levels. This continuum focuses on matching a patients need with the proper area of needed service. The three levels are primary, secondary ,and tertiary care. There is also an extension of tertiary care called Quaternary care as well. The primary care level of service focuses on a general health provider who will help examine the patient and if need be refer them to a specialist for further evaluation.
Boundaries should be seen as being statements about who a person is, about what they would like and want. They are about the person and each family member needs to be able to say what they want in regard to physical boundaries and these should be respected. Boundaries are also subject to change as they depend on the feelings of safety that a person has, every person has the right to change their boundaries. The recovering family will need to try out setting, maintaining and changing their boundaries with each other as they will have difficulty knowing how to do