Managed care organization

Sample Answer

What is a Managed Care Organization?

A Managed Care Organization (MCO) is a type of healthcare delivery system that aims to provide healthcare services to its members in a cost-effective manner while maintaining or improving the quality of care. MCOs achieve this by integrating the financing and delivery of healthcare, often through contracts with a network of healthcare providers (doctors, hospitals, specialists, pharmacies, etc.) who agree to offer services at negotiated, discounted rates.

The primary goal of an MCO is to control healthcare expenditures by managing the utilization of services, promoting preventive care, and fostering efficiency within the healthcare system. Rather than simply paying for services after they are rendered (as in traditional fee-for-service models), MCOs proactively manage and coordinate care for their enrolled members.