Managed Care Organization
A managed care organization is a collection of clinics, doctors, hospitals, pharmacies and other healthcare providers who come together to offer health care to persons who are sign up for the services. In many cases, managed care organizations operate and are referred to as networks of health care providers. Managed care organizations are comprised of health care experts from different fields who come under an agreement to offer health care services to members. Once a member signs up, all their heath care needs are covered by the managed care organizations. Access to care outside the organization is restricted. Members under managed care organizations are usually assigned a primary care physician (PCP) who is the primary care giver for the member. The PCP is tasked with analyzing a member’s health problem before referring them to other sections of the managed care organization. Managed Care Organizations are usually well coordinated to meet the needs of members who have registered under their banner.
Managed care organizations are created on the basis that they are a powerful tool in cutting health care costs. Therefore, these organizations are under pressure to enact measures that reduce costs of health care. One of the ways that managed care organizations attempt to control costs is by encouraging preventative rather than curative health measures. This means that these organizations encourage members to make lifestyle changes such as quitting smoking in order to avoid terminal illnesses that increase the cost of health care. In managed care organizations, members are also encouraged to take frequent tests which enable detection of diseases early thus making treatment cheaper. Taking the preventive route ensures that the organizations spend less by preventing diseases as opposed to offering treatment when conditions are advanced.
Managed care organizations also limit costs through the use of PCPs who are the primary care providers for members. In such organizations, PCPs are...