Good Essay On Services Offered By Hmos And Ppos

Part 1

Health insurance entails a coverage of an insured person’s surgical and medical expenses. Typically, the insured person meets insurance costs out of pocket or by the insurer depending on the type of insurance. Some of the insurance companies in my location include Anthem Blue Cross, Health Net, and blue shield (McKinlay, 2011). Notably, these companies operate as either PPOS or HMOs and benefit patients through a number of programs. The insurer offers services such as care plans, family support, educational programs, and disease management among others.
According to Stephen Wilson Pharmacy Seminar, In Moore, Wayne State University, & Wayne State University, 2012), direct care delivery to the insured characterizes the Health maintenance organizations (HMOs).The insured individual visits the medical providers with these organizations to seek services from the health practitioners. In most cases, the organizations (HMOs) only cover specialists in the provider network in reference to the suggestions of the primary care physician. Concisely, the HMOs negotiate fees for services provided to the insured individual. Consequently, the insured benefits because the costs are kept as low as possible
Alternatively, preferred provider organizations (PPOs) allow the patient to see a doctor of choice at any time (Tibbitts & Manzano, 2014). Such organizations negotiate prices with the laboratories, health professionals and care providers to decide on preferential prices. The providers who accept prices recommendations by the PPOs form part of the organization’s network.

Part 2

Firstly, holistic approach is inevitable when treating children. Often, children get sick many times and have to deal with infections time to time. Because the number of children suffering from chronic diseases is on the rise, it is paramount to approach their health holistically and make their lives pretty. In addition, the conventional way of approaching health care does not provide exact answers for children suffering from asthma and recurring infections (Tosheff & University of Waterloo, 2010). Moreover, the conventional drugs may only address symptoms and fail to heal children.
Secondly, holistic approach is paramount because patients of chronic diseases undergo suffering in all aspects of human nature. In essence, holistic approach considers the emotions, spirit, and the mind. Usually, it is essential to treat the entire body because the body is a system whose components interact and one can lead to the failure of another (Tosheff & University of Waterloo, 2010). Thus, it is paramount to have compassion for the patient and consider all aspects of treatment to make the process more patient friendly and respectful of cultural values and beliefs.

References

McKinlay, J. B. (2011). Health maintenance organizations. Cambridge, MA: MIT Press.
Stephen Wilson Pharmacy Seminar, In Moore, W. E., Wayne State University, & Wayne State University. (2012). Health maintenance organizations: impact on health and health professions: Proceedings. Detroit: Wayne State University College of Pharmacy.
Tibbitts, S. J., & Manzano, A. J. (2014). PPOs: Preferred provider organizations : an executive's guide. Chicago, IL: Pluribus Press.
Tosheff, T. L., & University of Waterloo. (2010). Healthcare and the environment: A holistic approach. Waterloo: University of Waterloo.