visits or procedures. Although this provided advantages to the patient and the physician, the trend changed to the HMO do produce further savings (Friedenberg, 1996).
Managed conventional coverage is a system in which patients or physicians must obtain prior authorization for hospitalization and expensive outpatient services. For PPOs known as point of service arrangements, insurance companies pay a standard negotiated fee. If the patient uses a preferred physician or hospital, the fee is paid with a small or no copayment; otherwise the PPO usually pays 80 percent. HMOs require the patient to use a doctor or hospital included in the HMO. It is predicted that in the future, HMOs will cover the majority of the nonelderly population (Sunshine & Evens, 1994).
Managed care has two goals in particular, to control health care costs and to provide quality services that are sufficient enough to satisfy the enrollees. Several strategies based on dir
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