Managed Health Care New Jersey
The concept of managed health care in New Jersey dates back to the 1970s particularly in 1973 when then President Ronald Regan enacted the Health Maintenance Organization Act. The act was aimed at improving health care in the United States by encouraging the growth of HMOs, managed care organizations. It is said that this act put a stopper in the inflation of medical costs during the 1980s by forcing discounts out of health care providers, and causing the industry to become more competitive and efficient.
Managed health care in New Jersey as well as in other parts of the United States is the term used to describe techniques aimed at reducing the costs of health insurance. This is achieved through contracts or agreements between companies and health care providers and medical facilities.
There are several main types of managed health care plans in New Jersey.
Health Maintenance Organization or HMOs are the oldest of these kind of managed health care plans in New Jersey. For a fixed yearly fee an HMO will allow a subscriber member access to a network of doctors and hospital facilities. Health premiums offered by HMOs are usually reduced in price but can sometimes be limiting and restrictive as compared to other managed health care plans in New Jersey. But the benefit of going with an HMO is that it is usually one of the cheapest types of managed health care plans in New Jersey, with co-payments also being very low if not free.
Preferred Provider Organization or PPOs are similar to HMOs but are a less restrictive type of managed health care plans in New Jersey. For example subscribers are allowed to pick their own doctor or physician instead of being restricted to one who is a member of the network. Of course a non-member would be more expensive. PPOs are different from other managed health care plans in New Jersey because they do not support the co-pay feature and instead use deductibles. Whatever the set deductible is, the patient needs to pay for out of his pocket, once the deductible is met the coinsurance portion applies and the PPO settles the balance.
Point of Service Plans or POS are similar to both of the managed health care plans in New Jersey that have been previously mentioned. Members of this type of managed health care plans in New Jersey do not make a decision about what type of managed health care plans in New Jersey they are to use until the point at which the service will be used, hence the name point of service.
Likewise if one were to need a specialist he would still have to get a referral from the network-affiliated physician. This gateway model can be a bit restrictive as well but it does give you the flexibility of choosing between both models when needed.
As ubiquitous as managed health care plans in New Jersey may be, it is still met with staunch criticism. Some believe that is had contributed to the decline of health care, but this remains to be proven and is much debated.