There are six different medical management committees typically formed within an MCO. Some serve operational purposes while others serve to meet regulatory and quality standard functions. Refer to the readings of this week and answer the following questions:
After answering the above questions, read the following information:
The development of MCOs has been influenced by the type of market they serve. For example, BCBS companies moved from primarily a service plan provider to a multiproduct line that includes HMO, PPO, and consumer choice plans. In addition, various types of managed care organizations have emerged due to forces imposed by the state and the federal governments, such as the HMO Act of 1973. Answer the following questions keeping in mind the above information: