Category: Managed Care Organizations

Managed Care Organizations (MCOs) are health plans that manage healthcare services to control costs while maintaining quality care through networks of contracted providers.  MCOs, such as HMOs and PPOs, employ strategies like preventive care, utilization management, and financial incentives to influence how members access services, thereby providing cost-effective, high-quality care.  Many states use MCOs to administer Medicaid and Medicare Advantage plans, receiving fixed payments per member to coordinate and deliver services.  How MCOs Work Contracting with Providers MCOs enter into agreements with hospitals, doctors, specialists, and other healthcare facilities to offer services to their members at negotiated rates.  Network-Based Care Members are encouraged or required to receive care withinLearn MoreManaged Care Organizations

Managed Care Organizations Healthcare Taxonomy Code 302F00000X HealthProviders DB is a comprehensive database of healthcare providers, including a complete directory of all Exclusive Provider Organizations. As of today, the following are the total number of Exclusive Provider Organizations nationally, in your state, and near your location. Medicare The following are the total number of Exclusive Provider Organizations that accept Medicare in your state, the number that have opted out of Medicare, and the total number excluded from participation in Medicare nationwide. Open App open_in_browser Alaska – Alabama – Armed Forces Pacific – Arkansas – American Samoa – Arizona – CaliforniaLearn MoreExclusive Provider Organizations