Managed Health Care  »

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 fi nancing 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 specifi c 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 fi nance

structure, such as a monthly premium or payroll tax, to ensure that money is available to pay for

the healthcare benefitsspecifi ed.

• 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 defined 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.

• financial incentives for enrollees to use service care efficiently.

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