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Basics of the U.S. Health Care System Chapter 9 Spring 2025 Exam Questions and Answers Managed Care - ....ANSWER ...-The cost management of healthcare services by controlling who the consumer sees and how much the service costs MCO - ....ANSWER ...-Managed Care Organization Why was managed care created? - ....ANSWER ...-Healthcare costs were spiraling out of control, providers could charge whatever they wanted for their services This was the first Managed Care Model - ....ANSWER Fee-for-service system - ....ANSWER ...-HMO ...-This is also known as an indemnity plan, increases the cost of healthcare because there are no controls on how much to charge for provider's service Capitation Rate - ....ANSWER ...-Paid at rate per patient, limits the amount the provider will be paid per service Characteristics of all MCOs - ....ANSWER ...-(1) Establish a relationship with organizations and providers to offer a designated set of services to their members (2) Establish a criteria for their members to utilize the MCO (3) Establish measures to estimate cost control …FOR STUDENTS ONLY…©️2025 ALL RIGHTS RESERVED… 1