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The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care ("managed care techniques"). It has become the predominant system of delivering and receiving American health care since its implementation in the early 1980s, and has been largely unaffected by the Affordable Care Act of 2010.
...intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as Health Maintenance Organizations and Preferred Provider Organizations.[1]
The growth of managed care in the U.S. was spurred by the enactment of the Health Maintenance Organization Act of 1973. While managed care techniques were pioneered by health maintenance organizations, they are now used by a variety of private health benefit programs. Managed care is now nearly ubiquitous in the U.S., but has attracted controversy because it has had mixed results in its overall goal of controlling medical costs.[2] Proponents and critics are also sharply divided on managed care's overall impact on U.S. health care delivery, which underperforms in terms of quality and is among the worst with regard to access, efficiency, and equity in the developed world.[3]
^Managed Care Programs. National Library of Medicine.
^WHAT IS MANAGED HEALTH CARE? by Christine Tobin
^"Mirror, mirror on the wall: how the performance of the US health care system compares internationally" (PDF). The Commonwealth Fund. June 2014. Retrieved August 5, 2018.
The term managedcare or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health...
Medicaid managedcare Medicaid and additional services in the United States through an arrangement between a state Medicaid agency and managedcare organizations...
Through the 1990s, managedcare grew from about 25% US employees with employer-sponsored coverage to the vast majority. Many managedcare programs are based...
The American Journal of ManagedCare is a monthly peer-reviewed medical journal published by ManagedCare & Healthcare Communications. The editors-in-chief...
American market.[citation needed] Luxottica also owns EyeMed Vision Care, a managed vision care organization in the United States. As of 2014, it is the second-largest...
The Department of Managed Health Care (DMHC) is a regulatory body governing managed health care plans, including Health Maintenance Organizations (HMOs)...
primary care physicians have begun to deliver primary care outside of the managedcare (insurance-billing) system through direct primary care which is...
Centene Corporation is a publicly traded managedcare company based in St. Louis, Missouri, which is an intermediary for government-sponsored and privately...
comprehensive care and accept the risk of managing total costs. Nationwide, roughly 80% of Medicaid enrollees are enrolled in managedcare plans. Core eligibility...
Molina Healthcare, Inc. is a managedcare company headquartered in Long Beach, California, United States. The company provides health insurance to individuals...
care as opposed to a fragmented system or a disorganized lack of system. The term has sometimes been used in a broad sense with reference to managed care...
Remedy to Balance Billing for Unavoidable Out-of-Network Care". The American Journal of ManagedCare. 23 (4). Retrieved 12 March 2023. "Emergency Medical...
the 1990s and 2000s. A major reason for this change was the advent of managedcare insurance plans,[clarification needed] which began to limit reimbursement...
The Affordable Care Act (ACA), formally known as the Patient Protection and Affordable Care Act (PPACA) and colloquially as Obamacare, is a landmark U...
development of managedcare, while advances in medical technology revolutionized treatment. In the 21st century, the Affordable Care Act (ACA) was passed...
Look up Care, care, -care, carer, or caring in Wiktionary, the free dictionary. Care may refer to: CARE (New Zealand), Citizens Association for Racial...
Kaiser Permanente (/ˈkaɪzər pɜːrməˈnɛnteɪ/; KP) is an American integrated managedcare consortium, based in Oakland, California, United States, founded in 1945...
CareSource is a nonprofit that began as a managed health care plan serving Medicaid members in Ohio. Today, it provides public health care programs including...
legitimate (i.e. supported by evidence) and conceivably reimbursable under managedcare health payment systems. Evidence-based guidelines are supported by one...
have lower premiums and higher copayments. Four managedcare plans began offering Commonwealth Care on November 1, 2006. Coverage for people above 100%...
Californians were in plans regulated by the California Department of Managed Health Care (DMHC) with about 60% regulated by either DMHC or the California...
arranges managedcare for health insurance, self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care providers...
treatment facilities. The Tricare program is managed by the Defense Health Agency. Before 1 October 2013, it was managed by the Tricare Management Activity under...
Affordable Care Act. As a Medicaid managedcare system, the plan has contracts with a number of private and nonprofit companies who provide care for a capitated...
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