managed care organisation

(1) A healthcare delivery system consisting of affiliated and/or owned hospitals, physicians and others, which provides a wide range of co-ordinated health services.
(2) An umbrella term for health plans that provide healthcare in return for a pre-determined monthly fee and co-ordinate care through a defined network of physicians and hospitals.

Examples
HMO, point-of-service (POS).

Features
A panel of contracted providers; some type of limitations on benefits to subscribers who use non-contracted providers, unless authorised to do so; an authorisation system; one of several types of organisations that pay and organise services and service providers with some degree of management (i.e., with protocols and limitations).

Mentioned in

References in periodicals archive

Meridian is a privately held, for-profit managed care organisation in the US and serves approximately 1.1m Medicaid, Medicare Advantage, integrated dual-eligible and Health Insurance Marketplace members in Michigan, Illinois, Indiana and Ohio.

(NYSE: WCG) has closed the acquisition of managed care organisations Meridian Health Plan of Michigan, Inc., Meridian Health Plan of Illinois, Inc., and pharmacy benefit manager MeridianRx, a pharmacy benefit manager, (collectively, Meridian) for USD 2.5bn in cash, the company said.

WellCare Closes USD 2.5bn Acquisition of Meridian to Expand Medicare/Medicaid Services

M2 EQUITYBITES-March 27, 2017-Trusted Health Plan Acquires Michigan Medicaid Managed Care Organisation

Trusted Health Plan Acquires Michigan Medicaid Managed Care Organisation

A managed care organisation, IlliniCare Health is a subsidiary of Centene (NYSE:CNC), a healthcare enterprise.

IlliniCare Health receives NCQA's accreditation approval for both its Medicaid and Exchange HMO plans

(NYSE: WCG) has entered into a definitive agreement to acquire managed care organisations Meridian Health Plan of Michigan, Inc., Meridian Health Plan of Illinois, Inc., and pharmacy benefit manager MeridianRx, a pharmacy benefit manager, (collectively, Meridian) for USD 2.5bn in cash, the company said.

WellCare to Acquire Meridian for USD 2.5bn to Expand Medicare/Medicaid Services