The Role that the Managed Care Organization Plays

The Role that the Managed Care Organization Plays
Managed Care Organization (MCO) is becoming relevant in the medical field. MCO is a health plan or company managing care as a model to reduce cost and ensure high-quality care (Bellot et al., 2017). Besides, different classifications of MCO include POS, PPOs, and HMOs. However, the most common among the three is the Preferred provider Organization (PPOs). HMOs are the most restrictive. Therefore, the substantive role of MCO is to supply cost-effective medical treatment. The paper comprehensively addresses MCO, its standards, regulatory statutes, and responsibilities.
Healthcare Administrative Role and MCO Standards
Health Care Organization's administrative role is to comply and interact with the MCO's procedures and standards through effective communication. HCO considers effective communication and flow of information as the suitable approach to compliance and executing risk management policies (Heaton & Tadi, 2022). HCO establishes an effective flow of information and coordination between care providers, MCO, and patients by promoting high-quality care. For instance, the key role of MCO is cost management; the healthcare provider must devise strategies that ensure affordable billing to adhere to the standards. Whenever they do not adhere to the standards, they may experience different consequences from MCO, such as service alteration. Besides, HCO embraces updated technologies that reduce health risks within the standards of MCO. The technologies must consider patient privacy and promote confidentiality. Therefore, HCO has a critical administrative role in adhering to MCO standards.
Regulatory Statutes of MCO and Policies
MCO regulatory statutes provide critical value to healthcare by enhancing the quality and managing cost. HCO and MCO work collectively through a well-established strategic approach to achieve higher quality healthcare at an affordable cost (Managed care organization, 2017). The main intention of the strategy is to ensure higher patient satisfaction. Risk management and shared beneficiary-cost sharing approaches in the healthcare organization reduce orga...