For the rest of employers, they would be protected in one of three ways -- all self insured employers would be protected from lawsuits in federal court, employers who offer fee-for-service insurance
would be protected because they are not making the medical decisions, or if they contract with the health plan to act as a liable decision maker.
Patients in New York state who undergo coronary artery bypass graft surgery and are covered by either private managed-care or Medicare managed-care insurance are significantly less likely than patients with fee-for-service insurance
to have the surgery done in hospitals with lower mortality rates, according to a study published in The Journal of the American Medical Association.
Under the old, fee-for-service insurance
system, there was too much inappropriate care and too much inefficiency.
Thus people insured by Medicaid--as well as people in private employer-based group plans or those who are shopping for insurance on their own--are being persuaded, urged, or even pushed to change from traditional fee-for-service insurance
plans to an HMO.
In addition, as the economy began to slow, employers grew alarmed at ever-increasing healthcare costs; traditional fee-for-service insurance
came to be viewed as a major pan: of the problem.
The cost of their care may be covered under Medicaid or a fee-for-service insurance
OR 95% CI visit length(*) 1.05 (1.03, 1.07) Fee-for-service insurance
0180 (0.64, 1.00) % time spent planning treatment([dagger]) 0.94 (0.89, 1.00) P visit length(*) <.001 Fee-for-service insurance
.046 % time spent planning treatment([dagger]) .047 (*) OR represents change in odds with every minute increase in visit length.
The base year utilization rates for physician office visits by females under the age of 18 with fee-for-service insurance
coverage were estimated to be as follows (Vector Research, Inc.
If, however, you go outside the plan, then you pay just like a fee-for-service insurance
and wait to be reimbursed, usually at a rate of 70%.
By contrast, fee-for-service insurance
pays for everything with very little emphasis on resource conservation (90% of Medicare recipients are in the fee-for-service program).
(Some HMOs cost up to 30 percent less than fee-for-service insurance
plans for an equivalent benefit package.)
By moving people out of traditional fee-for-service insurance
, the plans were supposed to resolve the problem of rising costs.