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Network Development in the Managed Care Organization. Network Development
in the Managed Care Organization To guarantee that its ...
... main factors that led to the development of different ... receive for medical treatment
outside of your managed care network. The first managed care plan that I am ...
... of the essential principles of managed care have eroded ... expensive to monitor a large
network of physicians ... went by the wayside because development of protocols ...
... An organized provider network allows not only for ... Furthermore, managed care contracting
is a complex enterprise and ... As a result, the development of protocols ...
... An organized provider network allows not only for ... Furthermore, managed care contracting
is a complex enterprise and ... As a result, the development of protocols ...
Submitted by crrhow on March 10, 2008
Category: Business
Words: 1375 | Pages: 6
Views: 94
Popularity Rank: 92,431
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Network Development in the Managed Care Organization
To guarantee that its members receive appropriate, high level quality care in a cost-effective manner, each managed care organization (MCO) tailors its networks according to the characteristics of the providers, consumers, and competitors in a specific market. Other considerations for creating the network are the managed care organization’s own goals for quality, accessibility, cost savings, and member satisfaction. Strategic planning for networks is a continuing process. In addition to an initial evaluation of its markets and goals, the managed care organization must periodically reevaluate its target markets and objectives. After reviewing the markets, then the organization must modify its network strategies accordingly to remain competitive in the rapidly changing healthcare industry. Coventry Health Care, Inc and its affiliated companies recognize the importance of developing and managing an adequate network of qualified providers to serve the need of customers and enrolled members (Coventry Health Care Intranet, Creasy and Spath, http://cvtynet/ ). “A central goal of managed care is containing the costs of delivering care, but the wide variety of organizations typically lumped together under the umbrella of managed care pursue this goal using combination of numerous strategies that vary from market to market and from organization to organization” (Baker , 2000, p.2).
To support the health plan’s organic growth strategies, pertinent business practices and operating guidelines related to new market development and significant service area expansion are designed to achieve goals and objectives. Some of these goals are establishing discipline around creating an existing or new market expansion business plan, framework for communicating business goals and priorities across the organization and establishing a means to inventory all expansion activity. As with any efficient...
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