managed care organisation

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).
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.
M2 EQUITYBITES-March 27, 2017-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.
(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.