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 in Managed Care Managed care Accessibility Controls costs Patient and provider incentives Utilization review Determine medical necessity of care Role as gatekeeper Different types of managed care plans Plan differences based upon cost and provider choice 15
Slide notes:Managed care manages the accessibility, cost, and quality of health care. Managed care plans control what contracted providers are paid and use cost-containment strategies, such as incentives for physicians and patients to choose less costly forms of care, and utilization reviews to determine the medical necessity of services. For these reasons, many people consider managed care to be a gatekeeper. Today, many versions of managed care plans exist, their differences are based primarily on cost and provider choice. 15