: BHS450 Managed Care..Case…Mod 3

Introduction In the United States, the term managed health care or managed care is applied to express an array of different concepts and techniques aimed at reducing the cost of providing health services as well as improving the service quality. Various health organizations and service providers use these techniques. Sometimes they even offer the techniques to other organizations which are often called Managed Care Organization (MCO). The United States National Library of Medicine defined managed health care program as an initiative or program of reducing unnecessary costs in the health care system by using assortment of mechanisms which include economic inducements and motivations for the patients and physicians to choose less expensive forms of health care, different programs and techniques for reviewing and improving the medical requirements in specific services, sharing amplified beneficiary rates, controls and monitoring the admissions of the patients and lengths of their staying in the hospitals, the issues of cost sharing as well as reasons for outpatient surgery. The health care programs and strategies may be provided in different settings within different systems, like Preferred Provider Organizations and Health Maintenance Organizations.

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