What entity integrates the financing and delivery of health care to covered individuals through selected providers?

Prepare for the NAB Domain 2 Operations Exam. Challenge yourself with multiple choice questions, detailed explanations, and study tips. Ace your test efficiently!

The correct answer is Managed Care Organization. This entity is specifically designed to combine the financing and delivery of healthcare services to improve efficiency and care quality for covered individuals. Managed Care Organizations coordinate medical care, which involves creating a network of providers that patients can choose from, often with an emphasis on cost-effectiveness and preventive care.

Managed Care Organizations typically implement strategies such as utilization review, care management, and negotiated rates with providers to control healthcare costs while ensuring that members receive adequate care. This integrated approach not only streamlines the process for patients but also aligns incentives for both payers and providers, encouraging the delivery of high-quality care.

In contrast, while Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs) are specific types of managed care structures, they do not encapsulate the broader operational framework that a Managed Care Organization represents. Accountable Care Organizations (ACOs) focus on improving care quality and reducing costs but may not integrate financing directly in the same way that Managed Care Organizations do.

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