What is a managed care system?
Summary. Managed care plans are a type of health insurance. They have contracts with health care providers and medical facilities to provide care for members at reduced costs. These providers make up the plan's network. How much of your care the plan will pay for depends on the network's rules.
What is the role of a managed care organization?
A managed care organization is a single organization which manages the financing, insurance, delivery and payment to provide health care services. Financing – the MCO and employer negotiates a fixed premium per enrollee and the health services provided in the contract.
What is the biggest advantage of a managed care plan?
Managed care tends to decrease or eliminate individuals' incentives to overuse services. It generally reduces patient out-of-pocket expenses and other financial barriers to health care. Managed care also has the potential to achieve better coordination of patient services.
What is an example of a managed care setting?
A good example of a managed care plan is a Health Maintenance Organization (HMO). HMOs closely manage your care. Your cost is lowest with an HMO. You are limited to seeing providers in a small local network, which also helps keep costs low.