health care insurance providers






health care insurance providers

Managed care is a synonym for PPO, HMO, MCO, and POS.

Managed care is a concept in U. S. health care which rose to dominance during the presidency of Ronald Reagan as a means to control Medicare payouts. As a major Medicare claims administrator, the Blue Cross-Blue Shield insurance firm was a major architect of managed care. It spread fairly quickly to the health insurance industry in the private sector. Health Care—Providing quality health, dental, vision, pharmacy and behavioral
health coverage for employees and their families.

Managed care is based on an effort to control escalating health care costs by the health insurance industry, which supposedly defines a reasonable maximum fee which health care providers may charge for any given service. Providers are ostensibly bound to accept these maximum fees if they wish to be listed in directories of specific insurance companies, which are provided to their policy holders as referral directories of "approved" physicians.

The rise of managed care was credited by the health insurance industry for the lessened rate of medical inflation seen in much of the 1990s in the U. S. , which in some years of that decade the rate of increase in price of medical goods and services was little more than the overall rate of general inflation. However, this effect now seems to largely have ended, and U. Health Insurance Portability and Accountability Act of 1996. S. medical inflation is once again two or three times the rate of overall inflation, as it was during much of the 1980s.

Forms of managed care

There are several forms of managed care. Ranging from more restrictive to less restrictive, they include:

Health maintenance organization (HMO)

Proposed in the 1960s by Dr. Paul Elwood in the "Health Maintenance Strategy", the HMO concept was promoted by the Nixon Administration as a fix to rising health care costs and set in law as PL 93-222.

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