Managed Care - CISMeF

Preferred Label : Managed Care;

NCIt definition : An arrangement whereby a third-party payer (e.g., insurance company, federal government, or corporation) mediates between physicians and patients, negotiating fees for service and overseeing the types of treatment given. Managed care has virtually replaced unmanaged indemnity plans, where payment is automatic and oversight procedures are minimal. Whereas 96% of American workers had unmanaged indemnity in 1984, only 28% did in 1988. Typically, in managed care, the third-party payer requires second opinions and pre-certification review for patients requiring hospital admission. They obtain wholesale prices from doctors, and carry out cost-containment measures, including auditing hospitals and reviewing claims. Managed care has figured heavily in the national debate over health care.;

Details

Origin ID

C15364;

UMLS CUI

C0086583;

Automatic exact mappings (from CISMeF team)
- Care management [LOINC component]
- Care manager (occupation) [SNOMED CT concept]
- care manager [Q-code]
- managed care programs [MeSH Descriptor]
Currated CISMeF NLP mapping
- managed care [MedlinePlus Topic]
- managed care [MeSH concept]
- managed care [NCCMERP Descriptor]
- managed care [NCCMERP Descriptor]
Semantic type(s)
- Health Care Activity [UMLS semantic type]
UMLS correspondences (same concept)
- managed care [NCCMERP Descriptor]
- managed care [NCCMERP Descriptor]
- managed care [MedlinePlus Topic]
- managed care [MeSH concept]

Keyword's position in hierarchy(ies) :

Main resources

You can consult :

recommendations
documents concerning education
documents for patients