Managed Care Organizations Review For Optometry: Blue Cross Blue Shield Of Michigan.

Background: This research study is designed to analyze the Blue Cross Blue Shield of
Michigan (BCBSM) health care program. Specifically, the study will break down the
characteristics that all managed care organizations obtain and how they relate to the
profession of optometry as well as the overall health care system. The study is geared
toward young optometrists interested in the business aspect of managed care issues in the
profession of optometry. I hope this research will improve the knowledge and judgement
needed to offer specific managed care plans in an optometry practice. Methods: In order to evaluate managed care organizations, BCBSM was chosen to be researched individually in order to correlate their specific characteristics to managed care
organizations as a whole. The research was acquired from the sources listed on the
references page. Results: BCBSM possesses many characteristics of a successful managed care organization. The organization has a long history of experience and success, along with a reliable administrative and management department. On the contrary, I feel that the program lacks appropriate benefits for eye care service based on reimbursement and follow-up care. Conclusions: In order to properly evaluate a managed care program, several areas should be researched thoroughly. The managed care program should meet the optometrist's practice goals and financial goals. The management structure and administrative leadership of the managed care organization should also be considered in the evaluation, as well as the reimbursement and payment schedules.