Managed healthcare is a summarizing term for various health care plans that attempt to manage growing medical care cost, utilization, and quality. Miya Health managed care system integrates the financing policy and delivery of appropriate health care using a comprehensive set of services to achieve the dual goals of controlling health care costs and managing quality of care.
By partnering with several reputed managed care organizations (MCOs), we provide quality health care services to beneficiaries, reduce medical care program costs and better MANAGE utilization of healthcare services. The primary intent of our managed care program is to reduce healthcare costs and improving health plan performance as well as quality on medical care.
Managed Care is a way for health insurers to help control costs by managing the healthcare services people use. Today, nearly all health insurance plans include a managed care component to control costs. One such component is pre-authorization: Members may need to receive approval from the insurance company before being admitted to a hospital or having a major procedure.
Over the years, managed care has given birth to several types of health plans, all in an effort to balance quality care with lower costs.
The program and policies to managed care encompass many types of organizations and insurance options, including:
• Health maintenance organizations (HMOs), which provide an array of services for a fixed or periodic prepayment.
• Preferred Provider Organizations (PPOs), consists of a group of hospitals, physicians and other healthcare industry-related providers who make a contract with an insurer, third-party administrator or other groups to provide health care services.
• Point-of-service policies, which combine the features of HMO and PPO.
Our managed care programs achieve the objective by controlling patient access to specialized care- integrating health care delivery and easy to access payment system, limiting healthcare provider fees by establishing fixed-rate slab for physicians and hospital services, and controlling drug costs.
Aside from these, cybercriminals are also targeting the healthcare industry for their vulnerability. Due to this growing unfortunate event, more and more hospitals are realizing the proper health care of patients not only involves medical attention but also entails securing the confidential medical data. Therefore, for healthcare organizations, Miya Health is an ideal managed care services provider and ensure transactions are seamless and patient data remains protected.