Services Offered by HMOs and PPOs
Part 1
In your location, identify three medical insurance providers that operate as HMOs or PPOs. What
are the types of services (disease management, case management, holistic care, care plans,
educational programs, family support, etc.) offered by the HMOs or PPOs and ways in which the
services have benefited your patients?
Part 2
Discuss two reasons why holistic care is necessary for individuals with chronic illnesses.
Part1. Medicare, Aetna health insurance, and Humana are some of the three medical
insurance providers in my location. They provide health care plans to their members. These
services help the members finance their health services or buy medicines when they are sick or
someone they are taking care of is sick. The insurance providers also provide educational
programs to its members on current health trends, what to avoid, and how to manage certain
conditions (Kongstvedt, 2013, Pg. 27).
Part2. I believe every nurse knows about Florence Nightingale’s devotion to taking care
of patients that could not take of themselves. Her emphasis on the connection between patients
and their environment has made her be considered as the first and greatest holistic nurses. In fact
she is branded “The Mother of Modern Nursing.” This just shows how significant holistic care is
in nursing.
HMOs and PPOs
For me, holism is more that certain activities performed or words spoken to the patient.
Holism is a philosophy; it is a means of ensuring that all parts of the patient obtain care. With
holistic care, nurses manage to recognize and treat each patient differently (Morton & Fontaine,
2013, Pg. 74). Some patients have been found describing holistic nurses as “those nurses that
truly care.” While there is nothing wrong with being goal-oriented or task-oriented in the nursing
field, if a clinician is overly task-oriented, he/she tends to become severely rushed leaving
patients feeling as if they are a burden or nothing else but a number. Holistic care aids nurses to
balance all their roles and responsibilities that come with the title hence; their duties become
their privileges and success
Secondly, holistic care entails healing the mind, body, and soul of the patients. It helps
nurses think about and assisting patients with consequences of a disease on the body, mind,
religion, emotions, and personal relationships. Holism involves taking into account the social and
cultural differences and preferences of the patients. I believe every person is his/her own
individual. Isn’t it essential then to individualize patient care?
HMOs and PPOs
References
Kongstvedt, P. R. (2013). Essentials of managed health care. Burlington, MA: Jones and Bartlett
Learning.
Morton, P. G., & Fontaine, D. K. (2013). Critical care nursing: A holistic approach.
Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.