Managed Health Care Plans

 

What is managed health care?

It's a system that controls the financing and delivery of health services to members who are enrolled in a specific type of healthcare plan.

The goals of managed health care are to ensure that..

• providers delliver high-quality care in an environment that manages or controls costs
• the care delivered is medically necessary and appropriate for the patients' condition
• care is rendered by the most appopriate provider.
• care is rendered in the most appropriate, least-restrictive setting.

  What are the major types of managed care plans?

• Health Maintenance Organizations ( HMO)
• Preferred Provider Organizations (PPO)
• Point-of Service (POS) plans

Each of these systems has distinctive features or characteristics.