managed care organization


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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 ?
Many managed care organizations use financial incentives that are linked to withholding tests, interventions, and specialist referrals.[32] Those with authority for a managed care organization's allocation of resources may have financial incentives that are linked to profits, low medical-loss ratios, or reduced use of services.
Managed care organizations should establish procedures for involving academic and research facilities and assistive technology manufacturers to participate in managed care organizations.
In 2001, managed care organizations will be required to identify enrollees with CHF and to track these patients along two performance measures: appropriate evaluation of left ventricular function and appropriate treatment with ACE inhibitors.
What managed care organizations may not realize is that good pain management may actually decrease costs, although more outcomes data are needed to convince administrators.
Ransom focuses on executive searches for CEOs, COOs, CFOs, physician executives and other senior management and clinical vice presidents and directors at hospital, health systems and related multispecialty physician group practices and managed care organizations. Based in Witt/Kieffer's Oak Brook, Ill., office, Ransom will concentrate searches in the firm's central region, but also assist clients nationwide.
Health plan members (patients, employees), employers who purchase health care for employees, and payers (managed care organizations) bicker over costs, premiums, benefits, quality, access to services, and choice of providers.
"Some managed care organizations have more stringent requirements for approving tests and procedures than InterQual has," Gallup adds.
Join us on Wednesday, July 31, 2019, from 12:30 1:30 PM Eastern as Brian OReilly, CPA & Partner and Koy Dever, Principal with BKD CPA & Advisors discuss how to assess your organizations financial position to move into new contract arrangements and what you specifically need to focus on to work with managed care organizations.
"I do think that the folks from our managed care organization that work with children in foster care are very passionate about what they do and want the best for these children."
States delivering services through a non-Medicaid managed care organization "must comply with the same requirements that would be necessary if such services were delivered through a managed care organization," officials from the Centers for Medicare & Medicaid Services said in a fact sheet about the proposed rule.
5 February 2014 - US healthcare cost containment services provider Stratose Inc said it had purchased local preferred provider organisation (PPO) network Arkansas Managed Care Organization Inc (AMCO), without disclosing the terms of the deal.
Consumers in 30 states have the option of at least one health plan operating on both the health insurance exchanges and as a Medicaid managed care organization, offering current Medicaid beneficiaries the choice of keeping their plan as their income increases, according to an analysis by Avalere Health.