There are several types of managed care organizations (MCOs). What is true about all MCOs?

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Prepare for the Health Care Finance 1 Test. Review flashcards and multiple-choice questions with hints and explanations. Get ready to excel in your exam!

Managed care organizations (MCOs) are designed with the aim of managing healthcare costs, improving quality of care, and ensuring efficient use of resources. The statement that all MCOs have an incentive to reduce utilization is accurate because reducing unnecessary healthcare services is a central goal of these organizations. By managing the level of care and focusing on preventive measures, MCOs strive to minimize costs while maintaining adequate service quality. This is achieved by implementing protocols, care management strategies, and utilizing networks of providers that comply with their standards.

In this context, the other options do not align with the fundamental structure and incentives of MCOs. MCOs do not provide free services universally; they typically operate under various payment models that involve cost-sharing with patients. Not all MCOs are nonprofit organizations; some may operate for profit, incorporating diverse business models. Additionally, MCOs often have limited networks of providers, which means that patients may not have unlimited choice when it comes to selecting healthcare providers, as MCOs work to control costs through predefined contracts with a specific group of providers. Thus, the incentivization to reduce utilization is a defining characteristic shared by all MCOs.

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