managed care organization


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managed care organization (MCO)

an organization that combines the functions of health insurance, delivery of care, and administration. Examples include the independent practice association, third-party administrator, management service organization, and physician-hospital organization.

managed care organization

Health insurance A health care delivery system consisting of affiliated and/or owned hospitals, physicians and others which provide a wide range of coordinated health services; an umbrella term for health plans that provide health care in return for a predetermined monthly fee and coordinate care through a defined network of physicians and hospitals Examples HMO, POS. See HMO, Point of service plan, PPOs.
References in periodicals archive ?
In addition, managed care organizations due to cost are unlikely to nurture and develop relationships.
When employers, managed care organizations, hospitals, and physician form partnerships, the health care value chain is formed.
Additional questions have been raised regarding the downstream risk providers' accountability for satisfying the legal, contractual, and quality standards that apply to the managed care organizations, their "upstream" contractors.
Unlike virtually all other managed care organizations, Henry Ford has created a highly structured program that grew out of its Center for Clinical Effectiveness, which stresses outcomes and utilization management, both essential aspects of a successfull managed care organization.
0 should lead managed care organizations to improve the systems by which they perform the measurements.
The activities traditionally performed by medical directors for managed care organizations, such as reconciling disputes on fee schedules and mediating "problem" claims, although important, will not continue to constitute their primary responsibilities.
He has since played an important leadership role in the success of several other managed care organizations including Cigna, where his team won the Platinum Award for the Y2K remediation of the core business application systems.
Later, MEDecision and Wellogic will work to give managed care organizations access to clinical patient information generated by providers.
Kessler practices health care law, representing a number of venture-backed and publicly traded emerging health care technology companies, managed care organizations, health care systems and health care providers.
Product Offers the Pharmaceutical Industry More Options and Flexibility in Evaluating Market Share Influences at Managed Care Organizations
that provides care management solutions and consulting services to managed care organizations, hospitals, physician organizations, and healthcare technology companies.
The ulcer therapy Prilosec is rapidly losing coverage at managed care organizations now that it is available over-the-counter (OTC), according to Verispan's spring 2004 Managed Care Formulary Drug Audit.