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Why have many insurers replaced retrospective health insurance plans with group plans, such as HMOs and...

Why have many insurers replaced retrospective health insurance plans with group plans, such as HMOs and PPOs?
 

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Answer #1

HMOs and PPOs are managed type of plans. It is the best plant in term of managing the cost and the beneficial outcomes. One can have full control on the expenditure of insurance and its outcomes. Retrospective plans do not have proactive influence because it is depends on the past experience and the past health data of patient. Retrospective payment method is quite different and unsafe, After the hospital gives the service, the insurer should learn or understand cost of the service and an insurance company (or third party) will pays based on that detail. Hence an insurer will replaces their retrospective plans with this type of hybrid HMOs and PPOs plan.

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