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 ?
Managed care organizations should provide point-of-service options which enable people with disabilities to chose an out-of-network provider for highly specialized services when necessary.
This group will study the impact of downstream risk on managed care organizations, providers, and consumers.
Finally, our respondents felt that career development programs may prove vital for ensuring that physicians stay energized and committed throughout their "corporate" fife at any given managed care organization.
The challenge for managed care organizations will be to recruit medical directors capable of being integral members of the management team.
Eduardo Alarcon and has since become a leading provider of medical management services for several managed care organizations.
and that managed care organizations are incentivized to control medical and pharmacy costs.
The National Directory of Managed Care Organizations Database is the most comprehensive and thorough directory available electronically today.
This guideline is consistent with market trends; many managed care organizations are now requiring that primary care physicians declare one specialty category rather than two (e.
The Executive Report on Managed Care will provide you with twice-monthly news and information on issues affecting the managed care industry, legislation and regulations, real-life examples of how managed care organizations are benefiting from innovative programs and cost saving initiatives.
Spiriva, Boehringer Ingelheim and Pfizer's treatment for chronic obstructive pulmonary disease, has gained formulary status at 81% of managed care organizations, according to Verispan's spring 2005 Managed Care Formulary Drug Audit.
Approximately 60% of all respondents were employed by managed care organizations, 40% by PBMs.
To conduct this evaluation, The Lewin Group met with each of the seven managed care organizations participating in HealthChoices, interviewed advocates for their perspective on the HealthChoices Program, and spoke with staff at the Pennsylvania Department of Public Welfare.