UNDERSTANDING MANAGED CARE - HMO's
What Is Managed Care?
Health Maintenance Organizations, commonly referred to as HMOs, represent one increasingly popular form of managed health care. This is a generic term that applies to different types of health care insurance arrangements. Managed care systems typically combine the financing and delivery of health services. They take care of this by financing, i.e. covering some or all of the cost of health care services and by delivery system. Delivery system means encouraging members to obtain services from the organization's network of providers. Under Managed Care, there are arrangements to obtain services from any provider, even out of network, but the health plan will pay more if the patient obtains care from a network provider.
Some of the most common managed care arrangements are:
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