What does "managed care" refer to in health insurance?

Managed care refers to a healthcare delivery system specifically designed to enhance the quality of care while controlling costs and managing the utilization of services. It encompasses various strategies aimed at optimizing patient care and ensuring that services provided are both necessary and appropriate. This approach often involves coordinating treatments and utilizing a network of providers to facilitate care, which helps to avoid unnecessary procedures and reduces overall healthcare expenses.

Managed care organizations typically implement protocols for patient care, standardized treatment plans, and preventive services to keep healthcare expenditures in check. Additionally, they may use a range of payment models, such as capitation or value-based care, to incentivize providers to focus on delivering efficient and effective care. This comprehensive approach to healthcare management is pivotal in achieving better health outcomes while minimizing costs for both insurers and consumers.

The other options do not accurately capture the essence of managed care. For example, while home health services may be part of managed care offerings, they are not the defining characteristic. Offering free healthcare does not align with the objectives of managed care, which inherently involves managing costs. Lastly, focusing solely on catastrophic events contrasts with the broader, proactive health management focus that managed care emphasizes.