Definition: HMOA HMO Definition: A Medicare HMO is an HMO that has contracted with the federal government under the Medicare + Choice program to provide health benefits to persons eligible for Medicare that choose to enroll in the HMO, instead of receiving their benefits and care through the traditional fee for service Medicare program.
Managed care is a complex system that involves the active coordination of, and the arrangement for, the provision of health services and coverage of health benefits.
The most common types of Managed Care Organizations (MCOs) include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs) and Exclusive Provider Organizations (EPOs.)
Managed care usually involves three key components:
oversight of the medical care given;
contractual relationships and
organization of the providers giving care; and the covered benefits tied to managed care rules.
