This will be comparing two health insurance companies that offer managed care plans. Three of the most popular managed care plans are Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Point of Service (P05), The two health insurance companies that will be concentrated on are Aetna and Blue Cross Blue Shield. They will be compared for their similarities and differences, their member/patient incentives, their innovations provided, their provider incentives, and their facility and patient satisfaction practices The preferred/recommended choice of the insurance company will be disclosed as well, The role of managed care plans is to reduce the costs for enrollees to receive health/medical services and to create a better-organized delivery of care to patients.
Specialized procedures, medications, treatments, and preventive care are all included in the services that healthcare professionals provide.
Managed care is a comprehensive system of care that is prepaid by either the individual or the government, or both, Contracts with healthcare providers and healthcare/medical facilities are included in managed care plans in order to supply services for enrollees at reduced costs.
Two companies, among many, that offer managed care plans are Aetna and Blue Cross Blue Shield. Aetna’s website is very easy to navigate through The information provided is detailed and easy to understand. In fact, Aetna received an award in 2011 for it’s easy to comprehend explanations of benefits, the animations, and the type of dialogue used of the website. There is a tool called David that was created by Aetna to help consumers better understand which health plans would best fit their needs.
It is clear that Aetna has taken the time to plainly and simply explain to potential and current enrollees exactly what they have to offer.
Throughout the website, one will clearly recognize that diversity is embedded into the Aetna company’s values The company has made positive gains in fostering partnerships with diverse groups and communities and encouraging diversity in the workplace environment. They have participated in national campaigns that seek to improve consumer health outcomes. They have a Physician Advisory Board that gives the company advice on the issues that are most important to physicians and improvements on business practices the company has received awards for their business practices, their use of innovative technologies, their dedication to their employees, and their diversity The company is consistently working, through their political action committee, to improve access to health care and standard quality of care, The company provides case management services; patient safety programs; disease management programs; and integrated behavioral health, dental, medical, disability, and pharmaceutical information.
Aetna has been highly ranked is one of the top payers in terms of business dealings with physicians the company had the lowest denial rate, and also took the least number of days to pay claims It was a bit more difficult to navigate through the Blue Cross Blue Shield (BCBS) website. However, a plethora of information is provided for both consumers and healthcare professionals BCBS has 37 independent companies across America. The company explains that they are collaborating with all stakeholders to build a better health care system. They have comprehensively detailed their recommendations to the government on an action plan to transform the health care industry. A couple of their recommendations are to reward safety strategies taken on by medical facilities and healthcare providers, and reinforce front line care. BCBS has also opened several retail insurance stores in Florida, South Carolina, North Carolina, New Jersey, and Kansas.
In these stores, customers can meet with an agent to discuss policies, get free health screenings, and participate in health related community events. Due to the fact that BCBS consists of 37 independent companies, one would have to search for information on what the BCBS company in their own area has to offer. Blue Cross Blue Shield plans use program-specific financial incentives for health promotion. The company has plans that reward preventive behavior. The insurance company also provides health promotion/education materials and programs, and also includes preventive care services in their benefit packages. The BCBS Technology Evaluation Center assesses medical technologies through extensive reviews of clinical evidence. The assessments are done to evaluate the clinical effectiveness of certain medical procedures, technologies, and medications BCBS appears to emphasize the importance of research and their innovative approaches to improvements in the health care quality sector.
The Blue Cross Blue Shield of North Carolina has offered a value-based insurance design program that eliminates copayments for generic drugs and reduces copayments for brand name drugs This program has helped to increase the enrollees’ adherence to their medications by a significant percentage. By BCBS offering this program, it is just one example of how determined the company is to improve health care quality and consumer health outcomes, Conclusion In conclusion, Aetna is the preferred choice of health insurance company. The first reason is that it has nationwide network coverage, compared to the 37 independent organizations under Blue Cross Blue Shield. Each independent BCBS is different, so there is not much uniformity in their operations and programs offered. Aetna plans also appear to be cheaper overall than BCBS plans. In addition, the Aetna website displays that it has a larger member size than BCBS and has a wider range of healthcare products to offer.
In the Aetna health insurance company and the Blue Cross Blue Shield insurance company were compared for their similarities and differences, their member/patient incentives, their innovations provided, their provider incentives, and their facility and patient satisfaction practices. Both companies had valuable innovative strategies in place to help improve consumer health outcomes, both companies have also made attempts to promote themselves to consumers on their benefits and what programs they have to offer. Blue Cross Blue Shield has opened several retail stores in five states across America Aetna has received awards for their information clarity and national health initiatives. The two companies are very strong competitors and though the preferred company here was Aetna, consumers can do their own research to find out which company best suits their needs in their area.