Managed Care Organizations and Integrated Health Care Networks

Discuss risk management’s role in managed care organizations (MCOs). The role of risk management is to identify risks inherent in managed care organizations, and hence limit financial losses and injuries, patients, visitors and employees. However, the healthcare sector is ever evolving, with laws, new regulatory frameworks, and regulations placing increased risks on risk managers in identifying and mitigating risks. Thus, the management has the obligation to provide quality health care as this would reduce costs, risk exposure of lawsuits, but will also increase patient satisfaction. Explain the patients’ conflict regarding an MCO and the family physician MCOs and physicians need to be cost effective, but this may bring conflicts with patients because physicians may typically spend lest time with patients. In essence, physicians result to spend less time on evaluating patients’ in order to cut on costs. A conflict arises in the physical patient relationship as both have different perspectives on the appropriate visit length time.

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