managed care

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A form of fiscal management of medical services used by health maintenance organizations and other health care organizations to allocate referral and treatment services. The effects on personal care should be imperceptible to patients, but sometimes excessive bureaucracy and rigid rules based on diagnosis-related groups about referrals can impede freedom of physicians and patients to select the optimum choice for individuals. The rapidly rising costs of managed care in the United States have caused concern to insurers and governments. Many comparative studies have shown that managed care in the United States is more costly than comprehensive tax-supported medical care services because of high administrative overhead, and that outcomes are usually inferior.

Subjects: Public Health and Epidemiology — Social Work.

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