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Type of health insurance system
the United States, managed care or managed healthcare is a group of activities intended to reduce the cost of providing health care and providing health
Managed_care
United States social health care program
comprehensive care and accept the risk of managing total costs. Nationwide, roughly 80% of Medicaid enrollees are enrolled in managed care plans. Core eligibility
Medicaid
The Department of Managed Health Care (DMHC) is a regulatory body governing managed health care plans, including Health Maintenance Organizations (HMOs)
California Department of Managed Health Care
California_Department_of_Managed_Health_Care
Italian eyewear company
American market.[citation needed] Luxottica also owns EyeMed Vision Care, a managed vision care organization in the United States. As of 2014, it is the second-largest
Luxottica
California implementation of Medicaid
services, instead of the managed care model. However, more than 879,000 Denti-Cal enrollees do receive dental care through managed care plans started as experimental
Medi-Cal
(Academy of Managed Care Pharmacy) is a professional organization representing the interests of pharmacists who practice in managed care settings. It
Academy of Managed Care Pharmacy
Academy_of_Managed_Care_Pharmacy
Through the 1990s, managed care grew from about 25% US employees with employer-sponsored coverage to the vast majority. Many managed care programs are based
Health insurance in the United States
Health_insurance_in_the_United_States
American-managed healthcare insurance company
Molina Healthcare, Inc. is an American managed care company headquartered in Long Beach, California. The company provides health insurance to individuals
Molina_Healthcare
between Medicaid managed care and Medicaid fee-for-service. In offering states access to rebates for drugs covered by Medicaid managed care plans, this policy
Medicaid_Drug_Rebate_Program
New York state health insurance plan
Amida Care is a New York State Medicaid managed care health plan for those with HIV/AIDS and other chronic conditions such as addiction, mental health
Amida_Care
American healthcare company
Meridian (Illinois and Michigan) Managed Health Care Services (Indiana) Iowa Total Care Sunflower Health Plan (Kansas) WellCare of Kentucky Louisiana Healthcare
Centene_Corporation
Academic journal
The American Journal of Managed Care is a monthly peer-reviewed medical journal published by Managed Care & Healthcare Communications. The editors-in-chief
The American Journal of Managed Care
The_American_Journal_of_Managed_Care
Managed health care company
(formerly Magellan Health Services Inc.), is an American for-profit managed health care company and subsidiary of Centene that focuses on special populations
Magellan_Health
Proposition 35, titled Managed Care Organization Tax Authorization Initiative, was a successful California ballot proposition in the 2024 general election
2024 California Proposition 35
2024_California_Proposition_35
U.S. Medicaid healthcare services contracting program
Medicaid managed care Medicaid and additional services in the United States through an arrangement between a state Medicaid agency and managed care organizations
Medicaid_managed_care
American integrated managed care company
Kaiser Permanente (/ˈkaɪzər pɜːrməˈnɛnteɪ/; KP) is an American integrated managed care consortium headquartered in Oakland, California. Founded in 1945 by industrialist
Kaiser_Permanente
development of managed care, while advances in medical technology revolutionized treatment. In the 21st century, the Affordable Care Act (ACA) was passed
Healthcare in the United States
Healthcare_in_the_United_States
Type of healthcare organization
accountable care organization (ACO) is a healthcare organization that ties provider reimbursements to quality metrics and reductions in the cost of care. ACOs
Accountable_care_organization
Virginia regulatory agency
principal function of the Managed Care Ombudsman is to help Virginia consumers who have health care insurance provided by a Managed Care Health Insurance Plan
State Corporation Commission (Virginia)
State_Corporation_Commission_(Virginia)
Process in American health insurance
(December 2012). "Prior Authorization for Safety, Not Just for Economy". Managed Care Magazine. Retrieved 20 May 2014. Brian Albright (1 January 2010). "Parity
Prior_authorization
Medical insurance group that provides health services for a fixed annual fee
arranges managed care for health insurance, self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care providers
Health maintenance organization
Health_maintenance_organization
Health Insurance Provider
CareSource is a nonprofit that began as a managed health care plan serving Medicaid members in Ohio. Today, it provides public health care programs including
CareSource
Academic journal
Journal of Managed Care & Specialty Pharmacy is a monthly peer-reviewed, open access, medical journal covering all aspects of managed care pharmacy. It
Journal of Managed Care & Specialty Pharmacy
Journal_of_Managed_Care_&_Specialty_Pharmacy
U.S. federal statute known as Obamacare
The Affordable Care Act (ACA), formally the Patient Protection and Affordable Care Act (PPACA) and informally known as Obamacare, is a landmark U.S. federal
Affordable_Care_Act
Healthcare organization
"DHCS Medi-Cal Managed Care Enrollment" (PDF). California Department of Health Care Services. Retrieved February 20, 2016. "DHCS Managed Care Plan Transition"
Partnership HealthPlan of California
Partnership_HealthPlan_of_California
Public agency in Los Angeles, California
Medi-Cal Managed Care: Reforming the Health System – Protecting Vulnerable Populations" which served as a blueprint for expansion of Medi-Cal managed care. It
L.A._Care_Health_Plan
American health care company
2025. webadmin (March 1, 1996). "United HealthCare Expands Presence in Southeast Region". Managed Care Magazine Online. Archived from the original on
UnitedHealth_Group
Services for the elderly or those with chronic illness or disability
into hospital"; in addition, "hospital studies" indicate M-LTSS (managed long-term care services) as billable services. In addition, allied health personnel
Long-term_care
System of managed care in the US used by state Medicaid agencies
Primary Care Case Management (PCCM) is a system of managed care in the US used by state Medicaid agencies, in which a primary care provider is responsible
Primary_care_case_management
US-based for-profit healthcare system
deliver healthcare across its hospitals and primary care locations, as well as through its managed care and health insurance services. At the start of 2024
Steward_Health_Care
Form of pseudoscientific alternative medicine
legitimate (i.e. supported by evidence) and conceivably reimbursable under managed care health payment systems. Evidence-based guidelines are supported by one
Chiropractic
Transfer of corporate ownership from the public to private sector
done so. In the United States, under the Medicare managed care the government pays a managed care organization (MCO) a fixed amount called the "capitated
Privatization in the United States
Privatization_in_the_United_States
Type of health insurance plan
or preferred provider option, is a managed care organization of medical doctors, hospitals, and other health care providers who have agreed with an insurer
Preferred provider organization
Preferred_provider_organization
2006 healthcare reform law in Massachusetts
have lower premiums and higher copayments. Four managed care plans began offering Commonwealth Care on November 1, 2006. Coverage for people above 100%
Massachusetts health care reform
Massachusetts_health_care_reform
U.S. Department of Defense health care program
treatment facilities. The Tricare program is managed by the Defense Health Agency. Before 1 October 2013, it was managed by the Tricare Management Activity under
Tricare
Topics referred to by the same term
Look up Care, care, -care, carer, or caring in Wiktionary, the free dictionary. Care may refer to: CARE (New Zealand), Citizens Association for Racial
Care
Tennessee Medicaid program
the first state Medicaid program to enroll all Medicaid recipients in managed care. When first implemented, it also offered health insurance to other residents
TennCare
US government health insurance program
coordinating the care of the dual-eligibles. There have been some proposals to transfer dual-eligibles into existing Medicaid managed care plans, which are
Medicare_(United_States)
Type of healthcare system in England
England, an integrated care system (ICS) is a statutory partnership of organisations who plan, buy, and provide health and care services in their geographical
Integrated_care_system
American health insurance company
WellCare Health Plans, Inc. is an American health insurance company that provides managed care services primarily through Medicaid, Medicare Advantage
WellCare
Type of medical organization
organizations that contracts with independent care delivery organizations, and provides services to managed care organizations on a negotiated per capita rate
Independent practice association
Independent_practice_association
Prevention of disease and promotion of well-being
primary care physicians have begun to deliver primary care outside of the managed care (insurance-billing) system through direct primary care which is
Health_care
American physician
drive profits through denial of care. On May 30, 1996, Peeno testified before Congress as to the downside of managed care. I wish to begin by making a public
Linda_Peeno
Type of health insurance plan in the United States
apply to some covered medications. Most Medicare Advantage plans are managed care plans (e.g., Preferred Provider Organizations (PPO) or Health Maintenance
Medicare_Advantage
Business management at the end of a lifecycle
be managed through multiple means, including public or industrial policy efforts such as government provision of retraining. The expression "managed decline"
Managed_decline
2002 American TV series or program
story of the real-life Linda Peeno, a physician and medical reviewer for managed care organizations who becomes a vocal critic of the American healthcare system
Damaged_Care
American health insurance company based in Louisville, Kentucky
HMHS was the managed care contractor for the Department of Defense Military Health System TRICARE South Region. In 2009, HMHS' Managed Care Support Contract
Humana
Type of health insurance
A point of service plan is a type of managed care health insurance plan in the United States. It combines characteristics of the health maintenance organization
Point_of_service_plan
Managed care approach to prescription
therapy, also called step protocol or a fail first requirement, is a managed care approach to prescription. It is a type of prior authorization requirement
Step_therapy
American health care organization
Spectrum Health System was a not-for-profit, integrated, managed care health care organization based in West Michigan. It bought out Beaumont Health of
Spectrum_Health
Oregon state Medicaid program
Affordable Care Act. As a Medicaid managed care system, the plan has contracts with a number of private and nonprofit companies who provide care for a capitated
Oregon_Health_Plan
A coordinated care organization (CCO) is a community based, integrated care organization created by the state of Oregon to allow for local and regional
Coordinated_care_organization
US health insurance company
acquisition of CareFirst". Modern Healthcare. Finance Staff (August 19, 2013). "CareFirst to offer mobile apps to manage health". Healthcare Finance. "CareFirst
CareFirst BlueCross BlueShield
CareFirst_BlueCross_BlueShield
Health service for former United States military personnel
Clinton Healthcare Reform proposal to determine if the VA was ready for managed care. The negative results of market research forced the VA system to re-evaluate
Veterans Health Administration
Veterans_Health_Administration
Specific approach for the coordination of community mental health services
This form of management is often a part of managed care systems and falls in legal trouble for coerced care, others include health maintenance organizations
Case management (mental health)
Case_management_(mental_health)
Type of health care system
care as opposed to a fragmented system or a disorganized lack of system. The term has sometimes been used in a broad sense with reference to managed care
Integrated_delivery_system
Medicare payment model for cancer care
Platform for OCM Participants Promises to Foster Value-Based Care". American Journal of Managed Care. Retrieved March 27, 2017. Dietsche, Erin (January 27,
Oncology_Care_Model
Public health insurance program in Minnesota, U.S.
Accessed 14 August 2007 Archived 21 June 2006 at the Wayback Machine Managed care reporting: Contracts Accessed 30 December 2012 "Prior HHS Poverty Guidelines
MinnesotaCare
American technology company
readmission rates. The study was published in The American Journal of Managed Care. In 2013, Inovalon partnered with Walgreens and electronic health record
Inovalon
Type or designation of pharmaceuticals
services." Managed care organizations contract with Specialty Pharmacy vendors. "Managed care organizations (MCOs) are using varied strategies to manage utilization
Specialty drugs in the United States
Specialty_drugs_in_the_United_States
American healthcare company
California, Wellpoint, and Carelon. It is the largest for-profit managed health care company in the Blue Cross Blue Shield Association. As of 2022, the
Elevance_Health
Payment arrangement for healthcare service providers
systems. Primary capitation is a relationship between a managed care organization and primary care physician, in which the physician is paid directly by
Capitation_(healthcare)
Hospital in Chicago, Illinois, US
Cook County, Illinois. Cook County Health also includes CountyCare, a Medicaid managed-care plan. Cook County Hospital was founded 1832,[clarification needed]
John H Stroger Jr Hospital of Cook County
John_H_Stroger_Jr_Hospital_of_Cook_County
Insurance holding company based in San Juan, Puerto Rico
Triple-S is the leading managed care company in Puerto Rico. With over one million customers, in addition to its core managed care business, TSM operates
Triple-S Management Corporation
Triple-S_Management_Corporation
Health care program in the United States
Program of All-inclusive Care for the Elderly (PACE) is a comprehensive model of health and social services for adults in the United States aged 55 and
Program of All-Inclusive Care for the Elderly
Program_of_All-Inclusive_Care_for_the_Elderly
Form of medicine review
of managed care techniques such as prior authorization that allow payers, particularly health insurance companies, to manage the cost of health care benefits
Utilization_management
Health care system for the U.S. military
health care and administrative-related services, including claims processing. The CRI project was one of the first to introduce managed care features
Military_Health_System
Health care facility with specialized staff and equipment
Remedy to Balance Billing for Unavoidable Out-of-Network Care". The American Journal of Managed Care. 23 (4). Retrieved 12 March 2023. "Emergency Medical
Hospital
New York-based health insurance subsidiary of Centene
Medicaid managed care plan, became a subsidiary of Fidelis Care. On September 12, 2017, it was announced that Centene Corp. would acquire Fidelis Care for
Fidelis_Care
Health care organization based in West Michigan
integrated, managed care health care organization based in West Michigan. Facilities include hospitals, treatment facilities, urgent-care facilities,
Trinity_Health_Michigan
American health economist
Journal of Managed Care & Specialty Pharmacy. 2 (6): 689–695. doi:10.18553/jmcp.2020.26.6.689. PMC 10394428. PMID 32463775. Academy of Managed Care Pharmacy
Sean_D._Sullivan
management is a managed care technique within the health care coverage system of the United States. It involves an integrated system that manages the delivery
Case management (US healthcare system)
Case_management_(US_healthcare_system)
US health care establishment
brought against Concentra and its subsidiaries, Concentra Managed Care MCOTooltip Managed care organization and Focus Healthcare Management PPOTooltip Preferred
Concentra
Standardized performance measurement system used in U.S. healthcare
Information Set (HEDIS) is a widely used set of performance measures in the managed care industry, developed and maintained by the National Committee for Quality
Healthcare Effectiveness Data and Information Set
Healthcare_Effectiveness_Data_and_Information_Set
accountable care system is a system of healthcare provision which is intended to be integrated, and in particular to merge the funding of primary care with that
Accountable_care_system
American health executive (1959–2019)
of integrated managed care consortium Kaiser Permanente, the largest such organization in the United States, which provides health care to 12 million
Bernard_Tyson
Medicaid managed care expanded across the country, safety net providers, such as Community Health Centers (CHCs) and public hospitals, feared that managed care
Association for Community Affiliated Plans
Association_for_Community_Affiliated_Plans
Type of medical clinic
medical care. A significant factor for the increase of these centers is significant monetary savings when compared to EDs. Many managed care organizations
Urgent_care_center
Branch of medicine devoted to mental disorders
the 1990s and 2000s. A major reason for this change was the advent of managed care insurance plans,[clarification needed] which began to limit reimbursement
Psychiatry
nurse-managed health center provides health care services in areas in the United States where there is limited access to health care. Nurse-managed health
Nurse-managed_health_center
United States prescription drug benefit for the elderly and disabled
Medicare Benefit, 2003, Nashville, Tenn[dead link] Managed Care Programs The American Journal of Managed Care Zhang J, Yin W, Sun S, Alexander GC. Impact of
Medicare_Part_D
Medical specialty
barrier-to-care issues seen in systems without specialists in emergency medicine, where patients requiring immediate attention are instead managed from the
Emergency_medicine
Indian healthcare company
multi-speciality facility, Even Hospital, in Bengaluru. The hospital operates on a managed care model that aligns provider compensation with health outcomes rather than
Even_Healthcare
Desirable level of functional or metabolic efficiency of a living being
"Transparency called key to uniting cost control, quality improvement". Managed Care. 13 (1): 38–42. PMID 14763279. Archived from the original on 17 February
Health
Person helping another with activities of daily living
A caregiver, care or support worker is a person who provides care for people struggling with their everyday activities due to age, long-term illness or
Caregiver
America corporate funded insurance plan
Self-funded health care, also known as Administrative Services Only (ASO), is a self insurance arrangement in the United States whereby an employer provides
Self-funded_health_care
usually 30-40%. Public hospitals in Argentina who have not converted to managed care principles are facing an influx of patients covered by privatized social
Health_care_in_Argentina
American businessman (1932–2026)
philanthropist. Abramson was best known for founding U.S. Healthcare, a managed care company that along with its parent company, Aetna, is now part of CVS
Leonard_Abramson
Academic discipline and profession
The 2000s saw the managed care movement, which aimed at a health care delivery system to eliminate unnecessary and inappropriate care to reduce costs,
Social_work
US term for medical professional providing first-line care
accessible location, familiarity, and increasingly issues of cost and managed care requirements. In many countries residents are registered as patients
Primary_care_physician
American trade association
coverage through the employer-provided, Medicare Advantage, Medicaid managed care, and individual markets. AHIP was formed in 2003 by the merger of Health
AHIP_(trade_association)
United States law
as the reduction of payments to Medicare managed care plans and the slowing of growth rates of these same care plans. The ten-year savings goal was $393
Balanced_Budget_Act_of_1997
2004 United States Supreme Court case
management and utilization review decisions by managed care entities like CIGNA and Aetna to a legal duty of care according to the laws of the State of Texas
Aetna_Health_Inc._v._Davila
American health system in Florida
either managed-care network was not necessarily exclusive, as All Children's Hospital was a member of both. The Hunter Group presented BayCare with a
BayCare_Health_System
Healthcare nonprofit
CareOregon is Oregon’s largest managed care administrator of the Oregon Health Plan (OHP), the state’s Medicaid program with about 500,000 members as
CareOregon
InterCommunity Health Network (IHN) is an integrated care coordinated care organization (CCO) formed by Oregon in 2012 to allow for local and regional
InterCommunity_Health_Network
Post-graduate internship
community pharmacy) and Managed Care Pharmacy residency in partnership with the Academy of Managed Care Pharmacy (AMCP) (based in managed care organizations such
Pharmacy_residency
Federation of 36 separate United States health insurance organizations and companies
cover most of their customers under managed care plans such as HMOs and PPOs which provide hospital and medical care in one policy. Blue Cross & Blue Shield
Blue Cross Blue Shield Association
Blue_Cross_Blue_Shield_Association
American mutual benefit corporation
and family health care plans. In 2008, the organization settled for $3 million with the California Department of Managed Health Care to resolve allegations
Blue_Shield_of_California
Integrated health plan and care delivery system
in 1992 as CareMore by Sheldon Zinberg and Johnn Edelston, President of HealthPro Associates through the merger of Community IPA managed by HealthPro
Carelon_Health
MANAGED CARE
MANAGED CARE
Girl/Female
Welsh
Pearl.
Girl/Female
Muslim
Special flower
Female
Welsh
Welsh form of Greek Margarites, MARGED means "pearl."
Boy/Male
Biblical
A comforter; a leader.
Boy/Male
Latin
Manager.
Girl/Female
Arabic, Muslim
Administrator; Manager
Surname or Lastname
English, Dutch, and German
English, Dutch, and German : occupational name for a retail trader, Middle English manger, monger, Middle Dutch manger, menger, Middle High German mangære, mengære (from Late Latin mango ‘salesman’, with the addition of the Germanic agent suffix).Norwegian : habitational name from a farmstead in southwestern Norway named as Mángr in Old Norse, perhaps from már ‘sea gull’ + angr ‘fjord’.
Boy/Male
American, French, German, Latin, Portuguese, Swiss
Royal; Kingly; Ruler; Manager
Girl/Female
Arabic, Muslim
One who Manages; Organiser
Girl/Female
Indian, Punjabi, Sikh
Manager
Boy/Male
American, Anglo, Australian, British, Danish, English, French, German, Jamaican, Polish, Swedish, Swiss, Teutonic
Man of Peace; Hero's Peace; Peaceful Strength; Strong
Girl/Female
Muslim/Islamic
Special flower
Girl/Female
Indian
Special flower
Girl/Female
Indian, Punjabi, Sikh
Manager
Boy/Male
Swedish English German Teutonic
Peaceful.
Boy/Male
Arabic
Guardian; Administrator; Manager
Boy/Male
Hindu, Indian
Manage; Dark
Boy/Male
Latin
Manager.
Boy/Male
Indian, Sanskrit
Difficult to Manage
Boy/Male
Muslim
Prudent. Manager.
MANAGED CARE
MANAGED CARE
Male
Hebrew
(חַשּ×וּב) Hebrew name CHASHSHUWB means "considerate." In the bible, this is the name of several characters, including a son of Pahath-moab.
Boy/Male
Bengali, Gujarati, Hindu, Indian, Kannada, Malayalam, Marathi, Oriya, Telugu
The King; Lord Vishnu
Boy/Male
Indian, Punjabi, Sikh
Love for Happiness
Boy/Male
African, British, English
Variant of Hilda
Surname or Lastname
English
English : from a Norman personal name composed of the Germanic elements hari, heri ‘army’ + bald, bold ‘bold’, ‘brave’.
Surname or Lastname
English
English : from Middle English plow ‘plow’, metonymic occupational name for a plowwright or plowman. In some cases it may have been a topographic name for someone who lived at the edge of an area of plowed land.
Boy/Male
Hindu, Indian
Famous; Glorious
Girl/Female
English French
Brit. A native of England: (Britain) or France:.
Girl/Female
Tamil
Onalika | ஓநாலிகாÂ
Image
Boy/Male
Gujarati, Hindu, Indian
Engrossed
MANAGED CARE
MANAGED CARE
MANAGED CARE
MANAGED CARE
MANAGED CARE
a.
Having fangs or tusks; as, a fanged adder. Also used figuratively.
p. pr. & vb. n.
of Manage
n.
One who manages; a conductor or director; as, the manager of a theater.
a.
Easily taught or managed; teachable.
n.
One who administers affairs; one who directs, manages, executes, or dispenses, whether in civil, judicial, political, or ecclesiastical affairs; a manager.
n.
General manager; factotum.
v.
The collective body of those who manage or direct any enterprise or interest; the board of managers.
n.
One who managed a petard.
a.
Not easily managed or effected; embarrassing.
a.
Admitting of being easily wielded or managed.
n.
The handling or government of anything, but esp. of a horse; management; administration. See Manege.
v. t.
To manage.
n.
Hence: Esp., to guide by careful or delicate treatment; to wield with address; to make subservient by artful conduct; to bring around cunningly to one's plans.
v. t.
To manage with skill and economy, as a housewife or other female manager; to economize.
imp. & p. p.
of Manage
n.
See Manage.
n.
Any one of numerous species of bright-colored singing birds belonging to Tanagra, Piranga, and allied genera. The scarlet tanager (Piranga erythromelas) and the summer redbird (Piranga rubra) are common species of the United States.
a.
Worn; fretted; as, a magged brace.
n.
To train in the manege, as a horse; to exercise in graceful or artful action.
n.
To treat with care; to husband.