Influencing Behaviors Through Managed Care

Examples of health promotion initiatives: ¬† gym membership discounts, healthy meals plans, employee newsletters, smoking cessation programs Utilization Review (UR)- ¬†review of the services delivered by a health care provider to evaluate the appropriateness, need, and quality of the prescribed services. Guards against unacceptable variation (not necessarily creative methods) in medical or pharmacy practice and … Continue reading

Managed Care Overview

Managed care (most commonly PPO’s)- prearranged discount for a network of physicians Synonyms for managed care: Health plan MCO Plan HMO Managed care all the efforts to influence behavior of patients (through financial incentives to get most cost effective care) and HC providers An entity involved in both the financing and delivery of HC Managed … Continue reading