MANAGED CARE ORGANIZATION

What is MANAGED CARE ORGANIZATION?

MANAGED CARE ORGANIZATION meaning Managed Care Organizations are entities that serve Medicare or Medicaid beneficiaries on a risk basis through a network of employed or affiliated providers. Stands for Managed Care Organization. The term generally includes HMOs, PPOs, and Point of Service plans. In the Medicaid world, other organizations may set up managed care programs to respond to Medicaid managed care. These organizations include Federally Qualified Health Centers, integrated delivery systems, and public health clinics. Is a health maintenance organization, an eligible organization with a contract under 1876 or a Medicare-Choice organization, a provider-sponsored organization, or any other private or public organization, which meets the requirements of 1902 (w) to provide comprehensive services.

 

reference: Centers for Medicare & Medicaid Services

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