Wisconsin Network Management Systems Agreement
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How to fill out Network Management Systems Agreement?
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FAQ
A Managed Care Organization (MCO) is a health plan or health care company that utilizes managed care as its model to keep the quality of care high while limiting costs. As part of a managed care system, an MCO agrees to offer its services at a reduced cost, along with other MCOs in the network.
In Wisconsin, there are several types of managed care plans, such as health maintenance organizations and preferred provider plans. A managed care health plan is a form of health insurance in which medical providers and facilities contract with an insurer to provide care at reduced costs.
Key Takeaways. States and territories have increasingly relied on managed care organizations, or MCOs?commercial insurance companies contracted by the state?to manage state Medicaid systems. While there is mixed evidence on managed care's impact on quality and costs, it is the predominant Medicaid delivery system.
HMOs Anthem Blue Cross and Blue Shield. Member Handbook. ... Chorus Community Health Plans. Member Handbook. ... Dean Health Plan. Member Handbook. ... Group Health Cooperative of Eau Claire. ... Group Health Cooperative of South Central Wisconsin. ... Independent Care Health Plan (iCare) ... MHS Health Wisconsin. ... MercyCare Insurance Company.
Health Maintenance Organizations require patients to have a family doctor who must provide referrals to other professionals in the same provider network. Preferred Provider Organizations are the most common managed care organizations and they allow patients to seek care outside the network for a slightly higher cost.