Traditionally, patients were required to pay for their medical fee after they receive their treatment or consultation service in what is referred to as a fee-for-service (FFS) manner. The amount charged was based on the set fee for laboratories, physicians, and procedures. Patients would either pay directly to the hospital or have part of the fee paid by an insurance company. While it sounds effective, such a system did not cover serious illnesses that required more money to diagnose. To cater to serious illnesses, Blue Cross came up with a plan that helped to cover them which has been the case over the last decade. However, this cover did not cater for visits to hospitals in which patients went for preventive checkups and tests as the insurance organizations feared that patients would misuse the opportunity and visit hospitals often for checkups.
Going for a preventive test and checkup is certainly less expensive than treating a serious illness. This is what brought forth the idea of health being viewed from a wellness perspective. With this, health maintenance organizations (HMOs) introduced the managed care concept in which physicians, hospitals, and specialists coordinated to provide wellness services (Managed Care, 2019) . These services included checkups and tests. The specialists are paid a constant fee every month despite the number of patients that visit. This way, those registered for the managed care program can go for checkups and hence identify critical illnesses at an early stage. Early detection and diagnosis allow for early treatment which is less costly to the patient and also insurance companies. Big financial indicators also show that managed care is a success as per the performance of the stockes of insurers in the health sector (https://www.fool.com/investing/general/2015/10/06/what-is-managed-care.aspx, 2015) . Care is improved as patients can now be allowed to regularly go for tests and checkups. The quality of care definitely goes up as early detection means that diseases can be treated easily (Chung & Mullner, n.d.) . Care, therefore, is not compromised but is improved.
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References
Chung, K., & Mullner, R. (n.d.). Managed care Health Insurance System . Retrieved from Britannica: https://www.britannica.com/topic/managed-care
https://www.fool.com/investing/general/2015/10/06/what-is-managed-care.aspx . (2015, October 6). Retrieved July 11, 2019, from The Motley Fool: https://www.fool.com/investing/general/2015/10/06/what-is-managed-care.aspx
Managed Care . (2019, May 22). Retrieved July 11, 2019, from MedilinePlus: https://medlineplus.gov/managedcare.html
