MCO Control
POST 1 – CARI SZAFRANSKY
The choice of insurance is a hustle and can affect both the patient and physician of their choice throughout the medical procedure. An insurance company will impact many factors when the patient needs to have a process done or go to a healthcare organization. For example, the type of healthcare provider, number of tests to be carried out, choice of a healthcare organization, number of days they can be admitted in the hospital, and the type and amount of drugs that the physician can prescribe. Managed Care Organizations (MCOs) are the organization that provides insurance and, in other words, dictates the quality of care that a patient can receive (Wager, Lee, & Glaser, 2017). The insurance companies often opt for too long methods that can be avoided if the physician’s prescriptions and ideas are followed where medical samples are given to the patients and are proven to be effective. Insurance companies dictating the number of medical trials carried out, and the procedures to be carried out before any medication is administered may cost both the patients and physicians a lot of money. Patients end up paying more money than they would have, and physicians end up doing double work, which they are not rewarded for adequately.
POST 2 – KATIE RANDELL
MCOs have a significant influence on where a patient can go to for treatment. Being a non-profit organization, the MCO works to reduce any possible losses that they may accrue. Making the MCOs be profitable may cause them to be careless as the organizations will be driven by the little profit they may enjoy (Kongstvedt, 2016). The number of tests that need to be carried out before the actual procedure is carried according to the MCOs requirements will not be necessary, saving both the patient and physician from the hustle.
References
Kongstvedt, P. R. (2016). Health Insurance and Managed Care: What They Are and how They Work. Jones & Bartlett Publishers.
Wager, K. A., Lee, F. W., & Glaser, J. P. (2017). Health Care Information Systems: A Practical Approach for Health Care Management. Wiley.