For Managed Care we have terms and definitions in 12 topics. The topics are Adolescent Mental Health, Blood and Marrow Transplant, Family Health, Health Care, Health Insurance, Insurance, Insurance Compensation, Mental Health, Mental Illness, Oncology, Senior Housing and Sociology.

Managed Care (Adolescent Mental Health)

A way to supervise the delivery of health care services. Managed care may specify which caregivers the insured family can see and may also limit the number of visits and kinds of services that are covered by insurance.

Managed Care (Blood and Marrow Transplant)

Term to describe various approaches to provide and pay for healthcare in an attempt to limit fees for health services and control or manage those services.

Managed Care (Family Health)

A healthcare delivery system under which physicians, hospitals and other healthcare professionals are organized into a group or “network” in order to manage the cost, quality and access to healthcare. Managed care organizations include PPO, HMO, EPO and POS.

Managed Care (Health Care)

Organized programs designed to control access to impatient and ambulatory health services, to ensure the medical necessity of the proposed service and the delivery of the service at the most efficient and cost effective level of care consistent with high quality. Managed care is essential to the structure of alternative delivery and financing systems, such as health maintenance organizations and preferred provider arrangements. The requirements can also be a component of traditional indemnity or fee-for-service health coverage.
Managed care may include pre-admission or pre-treatment certification, second surgical opinion programs, fee or price negotiation, pre-treatment protocol review, pre-admission testing, continued stay review, discharge planning, and individual/large case management. Failure to comply with managed care requirements or decisions usually reduces health benefit coverage for claims. The penalties may affect both the patient and the provider(s).

Managed Care (Health Insurance)

A medical delivery system that attempts to manage the quality and cost of medical services that individuals receive. Most managed care systems offer HMOs and PPOs that individuals are encouraged to use for their health care services. Some managed care plans attempt to improve health quality, by emphasizing prevention of disease.

Managed Care (Insurance)

Managed care is a philosophy of health care coverage that streamlines health services and creates a health-care system that includes both the financing and delivery of services to the consumer. It also takes more responsibility for maintaining subscribers' health, not just curing them once they are sick. It lowers costs by matching the patient with appropriate care as efficiently as possible. Different insurance carriers use different kinds of managed care. Although the philosophy is popularly associated with Health Maintenance Organizations (HMOs), other kinds of carriers also employ it.

Managed Care (Insurance Compensation)

A method by which insurance carriers attempt to manage healthcare costs by utilizing a pre-selected panel of physicians.

Managed Care (Mental Health)

An organized system for delivering comprehensive mental health services that allows the managed care entity to determine what services will be provided to an individual in return for a prearranged financial payment. Generally, managed care controls health care costs and discourages unnecessary hospitalization and overuse of specialists, and the health plan operates under contract to a payer.

Managed Care (Mental Illness)

A process used by insurers to reduce healthcare services deemed to be unnecessary.

Managed Care (Oncology)

Medical insurance coverage provided by a health maintenance organization. (See HMO above.)

Managed Care (Senior Housing)

There is currently no standard definition of managed care, but it can best be described as a combination of insurance and a health care delivery system. The basic goal of managed care is to coordinate all health care services received to maximize benefits and minimize costs. Managed care plans use their own network of health care providers and a system of prior approval from a primary care doctor in order to achieve this goal. Providers include: specialists, hospitals, skilled nursing facilities, therapists, and home health care agencies.

Managed Care (Sociology)

The reorganization of the health care delivery along corporate lines (see also HEALTH MAINTENANCE ORGANIZATIONS).

Similar

Browse words that start with:

• Ma
• Man
• Mana
• Manag

Browse All Terms by First Letter

Term Search