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Descriptor English: Managed Care Programs
Descriptor Spanish: Programas Controlados de Atención en Salud
Descriptor programas gestionados de la atención a la salud
Entry term(s) gestión de casos por el seguro de salud
planes de gestión del seguro de salud
Scope note: Planes de seguros de salud dirigidos a reducir costes innecesarios de la atención a la salud a través de diversos mecanismos, como incentivos económicos para médicos y pacientes para seleccionar formas de atención con costes más bajos, programas de revisión de la necesidad médica de servicios específicos, mayor participación de los costes compartidos, controles sobre hospitalización y su duración, establecimiento de incentivos para compartir los costes en la cirugía ambulatoria, contratación selectiva con los proveedores de atención de salud y gestión intensiva de los casos de atención de salud de alto coste. Los programas pueden ser provisionados en distintas formas, como los SISTEMAS DE PREPAGO DE SALUD y ORGANIZACIONES DE PROVEEDORES PREFERENTES.
Descriptor Portuguese: Programas de Assistência Gerenciada
Descriptor French: Programmes de gestion intégrée des soins de santé
Entry term(s): Care, Managed
Case Management, Insurance
Insurance Case Management
Managed Care
Managed Care Program
Managed Health Care Insurance Plans
Management, Insurance Case
Program, Managed Care
Programs, Managed Care
Tree number(s): N03.219.521.576.343.800
N04.590.374.410
RDF Unique Identifier: https://id.nlm.nih.gov/mesh/D008329
Scope note: Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: 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; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as HEALTH MAINTENANCE ORGANIZATIONS and PREFERRED PROVIDER ORGANIZATIONS.
Annotation: specify geog
Allowable Qualifiers: CL classification
EC economics
ES ethics
HI history
LJ legislation & jurisprudence
OG organization & administration
SN statistics & numerical data
ST standards
TD trends
Public MeSH Note: 90; was see under DELIVERY OF HEALTH CARE 1988-89
History Note: 90(88); was see under DELIVERY OF HEALTH CARE 1988-89
DeCS ID: 28152
Unique ID: D008329
Documents indexed in the Virtual Health Library (VHL): Click here to access the VHL documents
Date Established: 1990/01/01
Date of Entry: 1987/05/02
Revision Date: 1999/11/03
Managed Care Programs - Preferred
Concept UI M0012968
Scope note Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: 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; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as HEALTH MAINTENANCE ORGANIZATIONS and PREFERRED PROVIDER ORGANIZATIONS.
Preferred term Managed Care Programs
Entry term(s) Managed Care Program
Managed Health Care Insurance Plans
Program, Managed Care
Programs, Managed Care
Managed Care - Broader
Concept UI M0012969
Preferred term Managed Care
Entry term(s) Care, Managed
Insurance Case Management - Narrower
Concept UI M0012967
Preferred term Insurance Case Management
Entry term(s) Case Management, Insurance
Management, Insurance Case



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