Medical Plans 4.1

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Discussion Question #1 is comprised of two parts. Many perceive the HMO as the primary managed care vehicle. It is the most restrictive of all products available and in its purest form requires great control over the health care activities of its participants. For each of the questions posed below, provide a detailed response based on both your readings and opinion.  (A 1½-page response is required for the combination of Parts A and B.)   you must appropriately cite all resources used in your responses and document in a bibliography using APA style 

Part A

The traditional HMO requires a gatekeeper to control health care activities of the plan participant. Some plans have moved to an open-access model where the gatekeeper is no longer required. What impact does that have on the success of the HMO to control cost? Do you believe that gatekeepers are necessary? Why? 

Part B

A major question that arises when discussing managed care is who should be making health decisions for a patient: the patient’s doctor or the managed care plan? Discuss the issues on both sides of this question and state your opinion about how your position affects health care outcomes.