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Types of Managed Care Organizations

Gallagher Healthcare :: Industry Insights
By Gallagher Healthcare | 8/16/2018

Updated on 3/19/2020

The passing of the Health Maintenance Organization Act of 1973 allowed for the creation of managed health care organizations to better serve patients. If you are such an organization, Gallagher Healthcare has insurance solutions designed for your unique needs.

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What is the Definition of Managed Care?

Managed care refers to solutions that help to save money on healthcare while providing better services for patients. At its core, managed care includes provider networks that involve providers agreeing to specific standards and costs. In addition, managed care focuses on prevention and management of resources and utilization to help patients while reigning in costs.

What is a Managed Care Organization?

A managed care organization, by definition, is an organization that practices managed care principles. It is a health plan or health company which works to provide quality medical care at a cost-effective price. Healthcare organizations include providers such as hospitals, doctors and other medical professionals and facilities who work together on behalf of patients.

Types of Managed Care Organizations

Managed care organization examples include:

  • Independent Physician or Practice Associations
  • Integrated Delivery Organizations
  • Physician Practice Management Companies
  • Group Purchasing Organizations
  • Accountable Care Organizations
  • Integrated Delivery Systems
  • Physician-Hospital Organizations
  • Management Services Organizations, which can include group administrative purchasing and investment and management styles

Managed care organizations fall into three main categories. Health Maintenance Organizations require patients to have a family doctor who must provide referrals to other professionals in the same provider network. Preferred Provider Organizations are the most common managed care organizations and they allow patients to seek care outside the network for a slightly higher cost. Point of Service plans require patients to have a primary care doctor to oversee care and provide referrals, although out-of-network care is available at a slightly increased cost.

Managed Care Insurance

By definition, managed care insurance is more complex. As there are multiple providers and facilities in these organizations, robust policies which cover all eventualities are needed. Gallagher Healthcare offers solutions for all types of managed care. Not only do we provide insurance across the full continuum of care, but we understand the unique needs of managed care.

Gallagher Healthcare allows you to cohesively secure insurance from one insurer, saving you money. Gallagher Healthcare also offers premium discounts for those with stronger participation. We work hard to offer coverage with prior acts coverage and no disruption, reducing your need for tail coverage. Of course, if tail coverage is needed, there are plenty of solutions with Gallagher Healthcare.

Even one year of poor claims does not necessarily impact your premiums disproportionately since participants can work with Gallagher Healthcare to mitigate such a year. Since Gallagher Healthcare is a large program, we provide leverage to help you save long-term on renewals while offering you plenty of choices, both in terms of insurance solutions and defense counsel.

Contact Gallagher For A Free Quote

One of the strongest benefits of working with Gallagher Healthcare is our level of expertise. Our team already works with some of the largest managed care providers around the country and we understand the unique needs of this market. Since we recognize the unique needs of managed care provider models, we offer specific Solutions for Collaborative and Integrated Healthcare Organizations. Contact us for a quote today.

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