Managed Care Organizations (MCOs)

Managed Care Organizations (MCOs) are health care providers that offer services through a network of doctors, hospitals, and specialists. They aim to manage costs and ensure quality care by coordinating how patients access health services. Members typically pay lower out-of-pocket costs when they use network providers. MCOs emphasize preventive care and efficient resource management to reduce unnecessary expenses. They often use tools such as prior authorizations and care reviews to manage care delivery, ultimately aiming to improve health outcomes while controlling overall healthcare spending.