Author Question: What are the advantages and disadvantages of managed care organizations such as health maintenance ... (Read 109 times)

armygirl

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What are the advantages and disadvantages of managed care organizations such as health maintenance organizations (HMOs) and preferred provider organizations (PPOs)?

Question 2

You are ready to collect blood from a terminally ill patient who says, I don't want my blood drawn. I'm just going to die anyway.. How would you handle this situation?



prumorgan

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Answer to Question 1

One advantage of managed care organizations is that the cost of insurance for the policyholder can be reduced. Limiting the number of physicians a patient can go to and limiting the hospitals that the patient can be admitted to account for this reduction. The managed care organization negotiates better pricing with select health care facilities and physicians. This better pricing is used to control premium prices. The disadvantage is that the limitations restrict the patient's choices. If the patient goes outside of the selected health care facilities or uses physicians other than the ones the managed care organization has contracts with, the patient will pay higher deductibles for care.

Answer to Question 2

Extreme empathy and compassion must be demonstrated to the patient in this situation. The phlebotomist would best comment to the terminally ill patient with a statement such as, Your doctor has ordered some blood tests that I need to collect. You will have to talk to your doctor as to why more tests have been ordered. I understand how tired you are with all this testing. This will only take a minute.. Usually the patient will then allow the phlebotomist to collect the sample. If the patient continues to refuse, the physician will need to be consulted.



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