How do MCOs achieve cost-efficiencies by integrating the quad functions, risk sharing with providers, and care...
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How do MCOs achieve cost-efficiencies by integrating the quad functions, risk sharing with providers, and care coordination? What are some of the inefficiencies created by managed care? This original post should be no less than 400 words. |
Homework Answers
Ans)MCO was not really appealing during the 1980s because of HMO and its "shadow pricing".
- This pricing allowed lower premiums than indemnity insurance plans.
- Economic realities caused employers to pick MCO because of the increased price in private insurance.
- Inefficiencies: one is created for the provider who have to
deal with individual protocols and procedures.
- Providers were able to exclude several services.
- Lengthy appeal process that both patients and providers had to go
through.
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How do MCOs achieve cost-efficiencies by integrating the quad
functions, risk sharing with providers, and care...
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