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The managed care time clock: what's making it tick?

D F Beck1, J Dempsy

  • 1D.F. Beck & Associates, USA.

The Health Care Supervisor
|February 7, 1996
PubMed
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Managed care organizations (MCOs) are growing, using strategic pricing, networks, and care management to control costs while maintaining or improving patient outcomes. This article explores the interconnected elements crucial for MCO success.

Area of Science:

  • Healthcare Management
  • Health Economics
  • Public Health Policy

Background:

  • Managed care is experiencing significant growth, driven by the need for cost containment in healthcare.
  • Managed care organizations (MCOs) employ various strategies to achieve their objectives.
  • The effectiveness of MCOs in managing costs and outcomes is a key area of interest.

Purpose of the Study:

  • To examine the essential components of successful managed care organizations.
  • To illustrate the synergistic relationship between different facets of MCO operations.
  • To provide insights into the strategic elements driving MCO performance.

Main Methods:

  • Analysis of MCO operational strategies.
  • Examination of pricing practices.

Related Experiment Videos

  • Review of provider network structures.
  • Assessment of risk-sharing reimbursement models.
  • Evaluation of medical care management techniques.

    • Main Results:

    • MCOs effectively utilize pricing strategies and defined networks to manage costs.
    • Risk-sharing reimbursement and medical care management contribute to cost control.
    • MCOs achieve cost efficiencies without compromising, and sometimes improving, medical outcomes.
    • Interdependencies between MCO facets are critical for overall success.

    Conclusions:

    • Successful managed care organizations rely on an integrated approach.
    • Strategic alignment of pricing, networks, reimbursement, and care management is vital.
    • MCOs demonstrate a viable model for balancing cost and quality in healthcare delivery.