How Does Managed Care Impact A Healthcare Organization?
Healthcare organizations are always looking for ways to improve patient experiences, lower the cost of care, and keep themselves financially stable. The insurance, deductible, and payment models influence how a hospital operates from the cost of medical care, to the needs of their communities, to their revenue cycle management strategies, and much more.
Managed care is meant to unite medical professionals of all kinds, from independent primary care providers to large organizations, in order to provide a cheaper and more holistic approach to healthcare.
Since an MCO bundles hospitals, clinics, primary care offices, and specialized medical practices into one unified group, there are many ways to experience healthcare under this model, though prices should remain consistent. Being treated in-network means reduced costs for patient and provider alike, along with a smaller pool of healthcare professionals who are able to provide care and referrals to other in-network professionals. And because many people who receive health insurance through their employers do so through an MCO, it gives patients simpler, if sometimes restrictive, options for finding care.
However, one of the most important aspects of a managed care plan for the health care system is its relationship with Medicaid and the ongoing work of the Affordable Care Act.