Managed Care Organizations, Medicare, and Medicaid

Managed Care Organizations, Medicare, and Medicaid
Student’s Name
Institution
Managed Care Organizations, Medicare, and Medicaid
A Compare and Contrast Table

Similarities

Differences

Statement One v. Statement Two

* Both statements are concerned with the financial aspect of accessing healthcare.
* They also serve to provide enrolled patients with a variety of healthcare services.
* Since they both focus on the financial aspects, managed care organizations can be used to relieve the drain of Medicare resources by ensuring that the elderly patients and younger ones with chronic diseases have access to managed care (Medicaid.gov, n.d.a.), within their most suitable level of care

* Managed care organizations are healthcare providers who accept a capitation payment in exchange for providing managed care plans (Bellot, Valdez, Altdoerffer, Quiaoit, Bronzell-Wynder, & Cunningham, 2017). They are contracted by insurers to provide those services.
* Medicare is health insurance provided by the federal government and covers people who are over 65 years old or those below 65 years and have a disability or end-stage renal disease (Medicare.gov, n.d.).
* On one hand, the key objectives of managed care organizations are to reduce costs and increase the quality of care (Medicaid.gov, n.d.a.). The concept applied by managed care organizations to control the costs of healthcare is referred to as gatekeeping. It comes with its benefits, such as the reduced costs and improved quality of care as well as limitations, such as preventing patients from receiving the kind of care they want due to the financial restriction of managed care (Bellot, Valdez, Altdoerffer, Quiaoit, Bronzell-Wynder, & Cunningham, 2017).
* On the other hand, the key objective of Medicare is to provide health insurance to specific groups of qualified individuals (Medicare.gov, n.d.), rather than all Americans. However, individuals within these groups, especially those over 65 years, have a myriad of medical issues and as such, about half of the total medical expenses incurred by an individual in their lifetime are incurred after the age of 65 years (Barcellos & Jacobson, 2015). As such, Medicare financing is seen as expensive, although people overlook the benefits it presents.

Statement One v. Statement Three

* Both statements share the goal of addressing the high costs associated with the provision of healthcare services, which has ultimately affected the overall budget for healthcare.
* Both are also concerned with ensuring that people can access healthcare services at the lowest costs possible; managed care organizations for eligible people, regardless of their income levels and Medicaid for low-income people who cannot afford the high cost of healthcare under normal circumstances.

* While managed care organizations encompass healthcare providers who accept a capitation payment in exchange for providing managed care plans (Bellot, Valdez, Altdoerffer, Quiaoit, Bronzell-Wynder, & Cunningham, 2017), Medicaid entail...