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Which method of reducing healthcare costs is demonstrated in the following scenario?

After multiple visits to her primary care physician for concerns about the same problem, Aunt Sally could stay in the hospital for only 2 days for a preapproved procedure.

a. Minimal care system
b. Managed care system
c. Fee -for -service system
d. Reasonable reduction system

User Jitin
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1 Answer

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Final answer:

The described scenario demonstrates a managed care system, in which healthcare costs are managed through a preapproved procedure process for Aunt Sally, and is characterized by a fixed payment to providers, rather than payments for each service.

Step-by-step explanation:

The scenario described involves Aunt Sally being admitted to the hospital for a preapproved procedure after several visits to her primary care physician. This demonstrates a managed care system, where the healthcare provider is incentivized to reduce costs by managing the number of services provided. Such systems, like Health Maintenance Organizations (HMOs), involve a fixed payment per patient rather than additional payments for each service (“fee-for-service” system).

In a managed care system, providers are motivated to ensure that patients receive necessary, efficient care without unnecessary procedures. The preapproval process for hospital stays and procedures also serves as a mechanism to control costs. This is distinct from a fee-for-service system, where providers may be incentivized to offer more services to increase their earnings.

User Smaran
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