The Fee-for-Service plan is grounded on offering of defined traditional insurance service to cover the cost of services rendered to the consumer. FFS plan creates the least limitations for both the provider and consumer. Due to this minimal restraints resulting from it, the FFS plan has higher costs per degree of protection to the consumers.
The Preferred Provider Organizations is similar to the IPA but is mostly predicated upon selecting a subset of all available providers and making contractual agreements with them, which are dependent on price. This plan ensures that “preferred providers” have patients directed towards them by the PPO insurance plan in exchange for a lower price. This makes the PPO plan attracts a greater patient base that the PPO can apply to negotiate with providers.
The Point of Service plan (HMOs without walls) implies a capitation arrangement with providers for their enrollees, even though the doctors are distributed in their offices as in IPA or IPA. Additionally, the compensation for providers is per patient per year and not FFS. Also, patients have strong financial incentives to use POS plan doctors.
All the four plans ensure that both the consumers and the providers are not at any disadvantage in terms of provision and reception of healthcare services. Additionally, all the four programs are crafted to ensure each and every citizen gets access to quality affordable healthcare.
2. What roles have state and local health departments played in the delivery of health care services? Are these roles, in your view, appropriate and suitable in ensuring the protection of the public’s welfare? Should they be changed?
The state and the local health departments play crucial roles in the delivery of healthcare services to the American citizens. The government’s main role in the healthcare is licensing (Jonas et.al., 2007). The government permits both practitioners and institutions that provide Medicare. Licensing ensures that