Remit Guarantee Increase Revenue From Any Incentive Program!



Following the Trends of  Managed Care Organization (MCO) and Incentive Programs

                                                           The MCO Marketing Strategy

MCO's often follow a market strategy of building a broad geographic network in new markets. To enter widespread geographic markets, MCOs must win employer accounts to acquire more enrollees. To serve the medical needs of a geographically diverse population MCOs contract with local providers already practicing in the various locales where the MCOs have employer contracts.

HEDIS Evolution The growing predominance of managed care raised concerns that efforts to control costs may jeopardize quality. The move to develop quality report cards for health plans responded to these concerns. The reports cards can be used by employers and their employees to make health plan choices. Health Plan Employer Data and Information Set (HEDIS) established in 1989 has become the standards for reporting quality information on manage care health plans.

HEDIS is a quality tool that was the product of a partnership established in 1989 among health plans, employers and the National Committee for Quality Assurance (NCQA), which manages the HEDIS Programs.

Oh No! MCOs getting report cards - - what's next

INCENTIVE PROGRAMS