Healthspeak: The Language Of Managed Care

Here are some of the questions plans ask to determine whether a physician is meeting the plan's goals.

What Are the Differences In...

The most important test of the quality-of-care provided by a plan is whether patients get well and stay that way.

The two major types of managed care are health maintenance organizations (HMOs) and preferred provider organizations (PPOs). As managed care evolves in the U.S., the differences between these types of plans are blurring. Still, it's important to be aware that there may still be certain variations, including cost.

As part of their strategy to increase quality-of-care and control costs, many managed-care plans require patients to choose a primary-care physician (PCP)--usually a family practitioner, internist or pediatrician--to provide basic medical care.

Most managed-care plans fall into two major categories: the preferred provider orgnization (PPO) and the Health Maintenance Organization (HMO). Although there are differences among managed-care plans, they all aim to contain costs.

The ABCs of HMOs. Answers to commonly asked questions: How does managed care differ from traditional insurance? What are the differences between HMOs, PPOs and POSs? And much more.