Question

Regarding managed care plans, which of the following is most correct?A) Managed care plans focus on cost containment and quality improvement by coordinating healthcare services.

B) Managed care plans primarily prioritize unlimited access to any healthcare provider without restrictions.
C) Managed care plans do not involve any preauthorization processes for medical treatments.
D) Managed care plans have no impact on the coordination of healthcare services.

Answer 1

Managed care plans aim to improve healthcare quality and contain costs through coordinated services, and typically involve preauthorization for treatments. They utilize fixed payments to providers to reduce moral hazard and contain costs, contrasting with the unlimited provider access of fee-for-service plans.

Step-by-step explanation:

The most correct statement about managed care plans is that they focus on cost containment and quality improvement by coordinating healthcare services. Managed care plans, like Health Maintenance Organizations (HMOs), provide a structure for healthcare that includes a fixed payment per patient, rather than paying for each service as in a fee-for-service model.

Preauthorization processes are typically a feature of managed care plans, ensuring that provided services are medically necessary. Managed care plans may limit patients' access to providers within a network and require referrals for specialist services, contrasting with the unlimited access characterized by fee-for-service plans. By adopting such practices, managed care plans can effectively reduce moral hazard by aligning the incentives of providers with the goal of providing cost-effective health care.