Healthcare Management

April 24, 2013
When choosing an insurance plan it is beneficial to evaluate your own health. It is important to keep in mind how much you care you may need in the near future and whether you will be able to cover the costs of the medical you may receive. The Fee for Service option of health insurance is a traditional plan that offers defined coverage for billed charges for all services that are provided for the patient. This is not a very popular plan, especially among the working class. Fee for Service has also been slowly becoming an extinct insurance plan due to the increase patient purchasing of HMO’s or Health Maintenance Organization. (Phelps, 2010) The financial risk to consumers using the Fee for Service option is that there are higher costs due to the flexibility it offers to patients. Health risks to the consumers include the fact that usually preventative services are not generally covered to the patients. (All Business, 2013) This type of plan is ideal for patients that have little to no medical or health issues and concerns. The convenience of the Fee for Service is ideal for many patients such as being able to choose your own doctor and hospitals without interference from the insurance company.
In the Health Maintenance Organization, the insurance plan, doctors, and hospitals are all components of one organization. The doctors are salaried, the insurance plan owns the hospitals where patients are seen, and patients without emergency care are obligated to use the plan affiliates for their care. (Phelps, 2010) The financial risks associated with HMO’s are less compared to Fee for Service due to the cost control within the organization. The emphasis on preventative control in HMO’s will cause a reduction in illness and in turn reduce costs to the consumers. There is also, at times, very little to no out of pocket expenses associated with patients office visits and procedures. Some health risks to consumers include there being a long waiting period…