Health · Chapter 14 · Cost Containment
Managed Care / Medical Cost Management
Definition
Controlling how insureds use their coverage to contain costs. Four general approaches: mandatory second opinions · pre-certification review · ambulatory (outpatient) surgery · case management. Policy design tools include deductibles, coinsurance, and shortened benefit periods; plans also push preventive care.
In plain English
The insurer stops being a passive check-writer and starts steering how care gets delivered.
Easy to confuse with
These are what this term gets tested against — if you can't tell them apart cold, drill the contrast.
Related terms