An individual or group plan provides, or pays the cost of, medical care. A health plan combines health insurance coverage benefits under a product with a specific cost-sharing structure and provider network, within a geographic area. There are various types of health plans. ...
A health maintenance organization (HMO), one type of MCO, is a system that finances and delivers care to members and transfers some or all of the risks for the total cost of care from the insurer to the provider. The overall goals of MCOs are to provide quality patient care and to ...
The analysis of the increase in demand for health care clearly demonstrates the tradeoffs that will need to be made in this sector. The inclusion of excess capacity in the health care sector was essential to ensuring that this sector could respond to the increase in demand, as well as the a...
Godley P, Nguyen A, Yokoyama K, Rohack J, Woodward B, Chiang TI: Improving hypertension care in a large group-model MCO. Am J Health Syst Pharm. 2003, 60 (6): 554-64. PubMed Google Scholar Pre-publication history The pre-publication history for this paper can be accessed here:http...