Disclosure, rules crucial in managed care
IN AN ideal world, the managed- care system benefits all stakeholders - from insurers to hospitals, managed-care companies, doctors, and patients. Problem is, the world is far from perfect, and complications arise when parties' interests clash.
For the benefit of those who don't quite understand managed-care companies or third-party administrators (TPAs), these are typically doctor-led entities engaged by insurers and corporates to help manage rising healthcare costs.
Previously, companies' human resource (HR) departments would buy in-patient coverage from insurers and sign up individual doctors to provide outpatient health benefits to employees.
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