This is an insurance-based approach to reducing costs.

This is an insurance-based approach to reducing costs.

• A. Managed Care
• B. Case Managers
• C. Medicare
• D. Medicaid

Answer: (A)

Managed care is an insurance-based approach to reducing costs. It works by organizing care through provider networks, negotiating fixed rates, and using tools like prior authorization, gatekeeping, and utilization review to steer services toward more cost-effective options and appropriate use. By emphasizing preventive care and early intervention, it helps prevent costly hospitalizations and reduces unnecessary tests. Financial risk is shared with providers through methods such as capitation or shared savings, aligning incentives to control costs. Case management coordinates an individual’s care but isn’t itself a payment model or insurance structure aimed at cost containment. Medicare and Medicaid are government insurance programs, not the specific insurance design that reduces costs through network-based management and utilization controls.

Managed care is an insurance-based approach to reducing costs. It works by organizing care through provider networks, negotiating fixed rates, and using tools like prior authorization, gatekeeping, and utilization review to steer services toward more cost-effective options and appropriate use. By emphasizing preventive care and early intervention, it helps prevent costly hospitalizations and reduces unnecessary tests. Financial risk is shared with providers through methods such as capitation or shared savings, aligning incentives to control costs. Case management coordinates an individual’s care but isn’t itself a payment model or insurance structure aimed at cost containment. Medicare and Medicaid are government insurance programs, not the specific insurance design that reduces costs through network-based management and utilization controls.