MGEC34H3 Lecture Notes - Lecture 9: Preferred Provider Organization, Managed Care, Utilization Management
18 Dec 2016
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November 15, 2016 lecture 9: managed care. Can also have overprovision of healthcare services because of sid and. Response to overconsumption or overprovision: set up a system where physician practice must be managed in order to address high healthcare costs and the overprovision of services. It is tied together by its clinical (treatment) and fiscal (financial) accountability for the defined population. This means that there could be financial penalties on physicians that have higher volumes of services: often the organized delivery system is defined by its association with an insurance product. Differences between managed care and fee-for-service arrangements have to be measured along several dimensions, which would include: health of people receiving treatment; price of care; and, quality of care. Common characteristics of managed care are that most (if not all) care for a patient is provided in a network and resources are centralized in the network (via utilization review)
