MEDICINE: Types of managed care organizations and how they differ

Types of managed care organizations and how they differ Managed care involves health insurance companies contracting medical facilities and providers of health care to avail care to members at a cheaper rate. Their main aim is to administratively control cost and quality of medical services provided to their covered customers. These plans cover all or some costs of acquiring health care services. Members are required to get services from a stream of health providers who are approved by the specific insurance company. On the other hand, some plans permit members to get services from providers who are not approved thus providing less cover. There are four main types of managed care organizations and they all differs in terms of cost because the more flexible the plan is, the higher the cost and vice versa. They are: Health maintenance organizations restrict their care to providers who are within the network. It was established in 1960s by Dr. Paul Elwood. It is a coordinated system of delivery that incorporates both the delivery of medical services and financing to enrollees.

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