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Managed Healthcare has the potential to reduce the cost of providing health benefits and improve the quality of care for organizations that use systems of financing and delivering healthcare to enrollees organized around managed care techniques and concepts.

 

The intention is to reduce unnecessary healthcare costs through a variety of mechanisms economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; focusing on affordable generic essential drugs and the intensive management of high-cost healthcare cases. Among a targeted group such as a community or a business employer, an organization can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is available to pay for
the healthcare benefits specified.

 

Aim

Golden Zaneka organization of physicians and business leaders plan to offer better quality healthcare, encompassing prevention, early detection, one-stop management of ailments, through managed healthcare and membership services, using a business model with corporate social responsibility (CSR) and PPP.

 

Strategy

Setup integrated healthcare delivery systems ie. provider network.
• community medical centres with designated doctors and facilities with defi ned standards for
one-stop management for acute and chronic ailments.
• emphasis on preventive care and wellness incentives.
• formal utilization management and review leading to quality improvement programmes.
• fi nancial incentives for enrollees to use service care effi ciently.

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