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Managed Care

This category is for managed care organizations, including health maintenance organizations (HMOs), preferred provider organizations (PPOs), and other managed care arrangements.

Sites in Managed Care

Coventry Health Care, Inc.
[USA] A managed health care organization which offers HMOs and PPOs in many states. Site provides links to subsidiary organizations, offers investor information, and a company overview.
Health Plan of Nevada
[USA, Nevada] Offers HMO, Medicare HMO, PPO, and POS plans. Site includes information about plan options and benefits and a glossary. A subsidiary of Sierra Health Services, Inc.
Amerigroup Corporation
[USA] Provider of health care to low-income and uninsured families in several states and the District of Columbia. [English, some content in Spanish]
GatesMcDonald HealthPlus
[USA, Ohio] A managed care program providing medical care via workers' compensation for injured workers. Site describes company, its services, and allows provider lookup.
Pacificare Health Systems
[USA] A managed care health insurance company providing health plans for seniors, employer groups, families, and individuals. Includes areas for brokers, employers, and health care providers. Operates in western states and Guam.
American Specialty Health Plans of California
[USA, California] Offers health plans for chiropractic care and acupuncture. Site describes the company and includes directory of participating care providers.
Multimed
[South Africa] A medical scheme administrator. Services include managed care, claims management, and risk management.
First Health Group Corporation
[USA] Serves the group health, workers' compensation, and state public program markets in addition to offering claims services and clinical management. Site describes the company, its services, and offers consumer information.
Harvard Pilgrim Health Care
[USA] Nonprofit organization offers HMO, PPO, and POS plans in New England. Includes benefits, coverage, financial and employment information, and health news.
HealthSpring
[USA, Tennessee] A managed care organization in central part of state. Site describes products and services, allows provider search, and has areas for members, brokers, providers, and employers.
Molina Healthcare, Inc.
[USA] Provides managed healthcare in California, Washington, Utah, and Michigan, to individuals covered under Medicaid and related programs. [English, Spanish, Chinese, Russian, Vietnamese, and Hmong]
Medical Network One
[USA, Michigan] A for-profit organization committed to providing administrative services to physicians who have entered into both risk sharing and non-risk sharing agreements with managed care organizations.
Profit Line
[USA] Delivers high return, risk free managed care claim audit and recovery services to the managed healthcare industry.
County Managed Care Resource (COMCARE)
[USA, Pennsylvania] A program of the County Commissioners Association, which provides services and assistance to the counties implementing behavioral managed healthcare within the state HealthChoices program.
Prospect Medical
[USA, California] An affiliation of several managed care plans in the Greater Los Angeles area who have joined together to provide the full range of medical services to patients.
Ravenswood Physician Associates (RPA)
[USA, Illinois] An independent physicians association (IPA) of nearly 250 private practice physicians in Chicago and select northern suburbs. Providing insurance contract management and healthcare.
Concentra, Inc.
[USA] Provides occupational health services for cost containment and lost time prevention including: drug screens, physical therapy, first notice of injury, and case management.
Resolution Health Medical Scheme
[South Africa] Provides comprehensive, affordable medical cover to employer groups and individuals, and is supported by sound financial, administrative and medical controls.
Spectrum Managed Care
[USA, Texas] A workers' compensation managed care firm offering claims and case management, occupational networks, and medical bill and utilization review.
HealthHelp
[USA] Provides radiology management services for insurers and physicians. Its national radiology network is used by many managed care organizations.
AmeriChoice Corporation
[USA] Organizes health care benefits and services for beneficiaries of Medicaid and other government-sponsored health care programs in more than one dozen markets nationwide.
Lumenos, Inc.
[USA] Offers three phase program of consumer-driven healthcare, consisting of health savings account, traditional health coverage, and a health toolkit.
Definity Health, Inc.
[USA] A provider of consumer-driven health plans, consisting of an employer-funded personal care account, a traditional health coverage component, and an array of tools and resources to support its members.
Choice One, Inc.
[USA, North Carolina] Offers ongoing review and negotiation of managed care agreements for physicians with HMOs, PPOs, and POS programs. Has assisted in establishing several independent practice associations (IPAs).
Welsh Mountain Medical and Dental Center (WMMDC)
[USA, Pennsylvania] A primary care center serving everyone in Lancaster County. Offering programs to serve uninsured and low-income individual and families.
American Rehabilitation, Inc. (ARI)
Offers medical and vocational rehabilitation, telephonic claims reporting, telephonic case management, and medical networks.
CorVel Corporation
[USA] A national, independent provider of managed care and case management services for workers' compensation, accident and health, and auto insurance markets.
British Union Provident Association (BUPA)
[International] Provider of health insurance plans and services in several nations.
College Health IPA
[USA, California] A behavioral healthcare delivery system serving approximately 1.1 million members.
Keystone Mercy Health Plan
[USA, Pennsylvania] Medical assistance (Medicaid) managed care health plan in the southeastern region of the state.
National Medical Health Card Systems, Inc.
Offers prescription benefit management services to plan sponsors which include managed care organizations, local governments, unions, corporations and third party health care plan administrators. National network of licensed pharmacies, from Port Washington, New York. (Nasdaq: NMHC).
CORE, Inc.
Provides physician-intensive, specialty matched, healthcare utilization management programs which involve reviewing, evaluating and monitoring medical necessity and appropriateness of health care services prescribed for participants in health care plans, as well as worker's compensation bill review and case management services. (Nasdaq: CORE).
Health Risk Management, Inc.
Provides integrated health care management and information services to manage the quality volume and cost of health care under employee benefit plans. (Nasdaq: HRMI).
Healthcare Recoveries, Inc.
Provides health insurance subrogation and related recovery services for private healthcare payors. (Nasdaq: HCRI).
HealthExtras, Inc.
Provides supplemental health and disability benefit programs directly to consumers over the Internet. (Nasdaq: HLEX).
Physicians Health Services, Inc.
Managed health care company. (NYSE:HNT).
Humana, Inc.
Offers coordinated health insurance coverage and related services to employer groups, government-sponsored plans, small businesses and individuals. (NYSE:HUM).
Medical Control, Inc.
Holding company with subsidiaries which provide program of managed healthcare services to employers which self-fund their benefit programs, including healthcare cost containment programs. (Nasdaq: MDCL).

sub categories in Managed Care

Associations Associations
Preferred Provider Organizations [PPO] Preferred Provider Organizations [PPO]
Health Maintenance Organizations [HMO] Health Maintenance Organizations [HMO]
Resources Resources

cross references

Business : Financial Services : Insurance : Carriers : Life and Health Business : Financial Services : Insurance : Carriers : Life and Health
Business : Financial Services : Insurance : Carriers : Life and Health : BlueCross BlueShield Business : Financial Services : Insurance : Carriers : Life and Health : BlueCross BlueShield
Business : Healthcare Business : Healthcare
Business : Healthcare : Case Management Business : Healthcare : Case Management

other references

Business : Healthcare : Healthcare Management : Consulting Business : Healthcare : Healthcare Management : Consulting
Computers : Software : Industry-Specific : Insurance : Health Computers : Software : Industry-Specific : Insurance : Health
Society : Issues : Health : HMOs and Managed Care Society : Issues : Health : HMOs and Managed Care
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