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The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care ("managed care techniques").
Currently, managed care is the most common health care delivery system in Medicaid. In 2007, nearly two-thirds of all Medicaid beneficiaries are enrolled in some form of managed care – mostly, traditional health maintenance organizations (HMO) and primary care case management (PCCM) arrangements.
The Department of Managed Health Care (DMHC) is a regulatory body governing managed health care plans, including Health Maintenance Organizations (HMOs) and most Medi-Cal managed care plans in California.
Definition/Introduction. Managed care refers to a healthcare insurance approach that integrates healthcare financing and the delivery of care and related services to keep the costs to the purchaser at a minimum while delivering what is appropriate for a given patient or population.
Managed care. A term originally used to refer to prepaid health plans (generally, health maintenance organizations [HMOs]) that furnish care through a network of providers under a fixed budget and manage costs. Increasingly, the term is also used to include preferred provider organizations (PPOs).
Managed Care is a health care delivery system organized to manage cost, utilization, and quality. Medicaid managed care provides for the delivery of Medicaid health benefits and additional services through contracted arrangements between state Medicaid agencies and managed care organizations (MCOs) that accept a set per member per month ...
What is Medicaid managed care? Medicaid is one of the United States’ largest health insurance programs, providing care for almost 90 million people as of August 2023. Although Medicaid is often understood as safety net coverage for low-income people, its reach extends far more broadly.
A Managed Care Organization (MCO) is a health plan or health care company that utilizes managed care as its model to keep the quality of care high while limiting costs. As part of a managed care system, an MCO agrees to offer its services at a reduced cost, along with other MCOs in the network.
A method of managing the provision of health care to members with high-cost medical conditions. The goal is to coordinate the care so as to both improve continuity and quality of care and lower costs. Specific types of case management programs include catastrophic or large claim management programs, maternity case management programs, and ...
managed care, type of health insurance and system of delivering health care services that is intended to minimize costs. Managed care is specific to health care in the United States.