Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:Introduction to Health Care and Public Health in the U.S.
Unit:Financing Health Care - Part 1
Lecture:Payors in the U.S. Health Care System
Slide content:The Managed Care Business Model Integrates financing and delivery using managed care techniques Provider reimbursement Comprehensive quality medical care Features : Controlled access to comprehensive care Reduce costs Improving quality care Rationing and quality of care concerns 13
Slide notes:A managed care organization, or MCO, is a business model that integrates financing and delivery of health care, using managed care techniques. Managed care can be separated into two distinct functions: one is the methodology and techniques used for provider reimbursement, and the other is the provision of comprehensive quality medical care. Managed care organizations share common features. All have controlled access to comprehensive care and manage the care provided using various techniques designed to reduce costs yet improve the quality of care. Patient concerns about rationing and the quality of care received through withholding of services by early health maintenance organizations resulted in new managed care models. 13