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Assignment 16

The healthcare industry implemented Managed Care to address key questions regarding cost, care sources, and payment by consolidating these elements under one organization, regulating costs and provider access. Medicare coverage consists of four parts: Part A provides hospital insurance, Part B covers outpatient and preventive services, Part C includes Medicare Advantage Plans with additional benefits, and Part D offers prescription drug coverage. These components work together to ensure comprehensive healthcare coverage for beneficiaries.

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24 views1 page

Assignment 16

The healthcare industry implemented Managed Care to address key questions regarding cost, care sources, and payment by consolidating these elements under one organization, regulating costs and provider access. Medicare coverage consists of four parts: Part A provides hospital insurance, Part B covers outpatient and preventive services, Part C includes Medicare Advantage Plans with additional benefits, and Part D offers prescription drug coverage. These components work together to ensure comprehensive healthcare coverage for beneficiaries.

Uploaded by

t33j007
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Due April 12

Assignment #1 Chapter 16
 What are the four reasons why the healthcare industry implemented
Managed Care?
o The main questions in regards to insurance are, how much is it going
to cost, where will the care come from, and who is going to pay for it?
The answers to these questions are often scattered around, so
managed care plans were implemented to bring answers to these
questions all under one organization. In doing so, they regulate the
cost of care and what providers the patient can go to for a service. At
the same time, the insurance company becomes the single payer.
 What are the four “parts” of the Medicare coverage? Explain each.
o Part A- Hospital Insurance: This part of Medicare provides inpatient
hospital coverage, inpatient skilled nursing facility coverage, access to
home healthcare services, and hospice care if necessary.
o Part B- Supplemental Medical Insurance: This part provides coverage
for visits to physicians, outpatient treatments, and preventative
services.
o Part C- Medicare Advantage Plans: Allows individuals to enroll in
capitated health insurance plans that provide the same benefits
covered under traditional Medicare, and may offer additional benefits.
o Part D- The Prescription Drug Benefit: This makes prescription drug
coverage available through various Medicare-approved prescription
plans.

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