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Managed care health plans are designed to control healthcare costs by controlling which healthcare providers members can access in addition to managing the utilization of services to reduce unnecessary treatment. Today, there are three primary types of managed care plans: Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Point of Service (POS) plans.

Why Managed Care Matters:

Managed care impacts clinical, financial and executive roles in different ways. States and providers are at different stages in the transition to managed care and value based care. Before entering into managed care contracts, executive teams at behavioral health organizations need to accurate assess costs and forecast the expected revenue and risk.

How You Need to Adapt:

To adequately prepare for the demands of managed care, clinicians and executive teams need to implement technology solutions that can give them insight into the costs associated with treatment and the ability to monitor service utilization enterprise-wide.

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