What is Managed Care?

• A. A system that provides unlimited choice of doctors with no cost controls.
• B. A plan that focuses on fee-for-service payments to providers.
• C. A system that manages cost, quality, and access to health care.
• D. A model that assigns patients to random providers.

Answer: (C)

Managed care is a system that coordinates and oversees health services to control costs, improve quality, and ensure access to care. It uses networks of providers at negotiated rates, often with a primary care physician acting as a gatekeeper to coordinate care and referrals. Utilization management and preventive services are emphasized to avoid unnecessary procedures and keep care appropriate. Payment methods like capitation or negotiated discounts help align incentives to deliver value, not just more services. This approach contrasts with unlimited choice with no cost controls, which would miss the cost-containment and coordination goals, and with fee-for-service models that pay for each service without strong incentives to control overall costs or coordinate care. It also differs from random provider assignment, which undermines continuity and accountability.