US Health Care System
US Health Care System
An
explanation of what a managed care organization (MCO) is and how
MCOs
evolved
The identification of the accrediting bodies for MCOs and an explanation of the types of care they oversee.
A description of managed care plans, such as HMOs and PPOs
explanation of the impact of MCOs on cost, access, and quality.
An explanation of what accountable s 3/19/15
What is managed care organization (MCO)?
Managed Care is a system that s structured to regulate cost, operation, and value of care, which provides the distribution of health benefits and addition to the services that are negotiated from state to state
Medicaid groups. This would also include
Medicaid organizations and managed care associations (MCO) that collects from every member on every month.
3/19/15
MCOs Evolves.
HMO- Require a lower copayment for an doctors visit, hospital stays, and for pharmaceuticals. A monthly flat fee is collected from everyone that is under their plan
FFS- fee-for-service covers all medical expenses , with no provider networks or tiers to follow.
IPA - Independent Physician Association, physicians that join together as a network, but independently negotiate with other organizations who are contracted with one or more
MCO organization .
PPO- Preferred Provider Organization allow visits to innetwork doctors or healthcare provider with out a referral from the primary doctor.
POS- Point of Service Plans is a plan that mimic HMO’s and
3/19/15
PPO’s, the levels of benefit depending on care received in –
The identification of the accrediting bodies for MCOs
• What is Accreditation?
Accreditation is a health plan arbiter to measure effective service. 3/19/15
Identification of the accrediting
•Access and Services•Qualified Providers
•Mantling good health
•Health continues plans to getting health
•Living with Illnesses
3/19/15
Why is Accreditation
Important?
Accreditation is important to inspire health plans developers to effectively improve quality, and
An
explanation of what a managed care organization (MCO) is and how
MCOs
evolved
The identification of the accrediting bodies for MCOs and an explanation of the types of care they oversee.
A description of managed care plans, such as HMOs and PPOs
explanation of the impact of MCOs on cost, access, and quality.
An explanation of what accountable s 3/19/15
What is managed care organization (MCO)?
Managed Care is a system that s structured to regulate cost, operation, and value of care, which provides the distribution of health benefits and addition to the services that are negotiated from state to state
Medicaid groups. This would also include
Medicaid organizations and managed care associations (MCO) that collects from every member on every month.
3/19/15
MCOs Evolves.
HMO- Require a lower copayment for an doctors visit, hospital stays, and for pharmaceuticals. A monthly flat fee is collected from everyone that is under their plan
FFS- fee-for-service covers all medical expenses , with no provider networks or tiers to follow.
IPA - Independent Physician Association, physicians that join together as a network, but independently negotiate with other organizations who are contracted with one or more
MCO organization .
PPO- Preferred Provider Organization allow visits to innetwork doctors or healthcare provider with out a referral from the primary doctor.
POS- Point of Service Plans is a plan that mimic HMO’s and
3/19/15
PPO’s, the levels of benefit depending on care received in –
The identification of the accrediting bodies for MCOs
• What is Accreditation?
Accreditation is a health plan arbiter to measure effective service. 3/19/15
Identification of the accrediting
•Access and Services•Qualified Providers
•Mantling good health
•Health continues plans to getting health
•Living with Illnesses
3/19/15
Why is Accreditation
Important?
Accreditation is important to inspire health plans developers to effectively improve quality, and