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Managed Care

  • Health Maintenance Organizations [HMO]
  • Preferred Provider Organizations [PPO]


  • Associations
  • Consulting@
  • Issues@
  • Resources
  • Software@

  • See also


    • American Rehabilitation, Inc. (ARI)
      Offers medical and vocational rehabilitation, telephonic claims reporting, telephonic case management, and medical networks.
    • American Specialty Health Plans of California
      [USA, California] Offers health plans for chiropractic care and acupuncture. Site describes the company and includes directory of participating care providers.
    • AmeriChoice Corporation
      [USA] Organizes health care benefits and services for beneficiaries of Medicaid and other government-sponsored health care programs in more than one dozen markets nationwide.
    • Amerigroup Corporation
      [USA] Provider of health care to low-income and uninsured families in several states and the District of Columbia. [English, some content in Spanish]
    • British Union Provident Association (BUPA)
      [International] Provider of health insurance plans and services in several nations.
    • Choice One, Inc.
      [USA, North Carolina] Offers ongoing review and negotiation of managed care agreements for physicians with HMOs, PPOs, and POS programs. Has assisted in establishing several independent practice associations (IPAs).
    • College Health IPA
      [USA, California] A behavioral healthcare delivery system serving approximately 1.1 million members.
    • Concentra, Inc.
      [USA] Provides occupational health services for cost containment and lost time prevention including: drug screens, physical therapy, first notice of injury, and case management.
    • CorVel Corporation
      [USA] A national, independent provider of managed care and case management services for workers' compensation, accident and health, and auto insurance markets.
    • County Managed Care Resource (COMCARE)
      [USA, Pennsylvania] A program of the County Commissioners Association, which provides services and assistance to the counties implementing behavioral managed healthcare within the state HealthChoices program.
    • Coventry Health Care, Inc.
      [USA] A managed health care organization which offers HMOs and PPOs in many states. Site provides links to subsidiary organizations, offers investor information, and a company overview.
    • Definity Health, Inc.
      [USA] A provider of consumer-driven health plans, consisting of an employer-funded personal care account, a traditional health coverage component, and an array of tools and resources to support its members.
    • First Health Group Corporation
      [USA] Serves the group health, workers' compensation, and state public program markets in addition to offering claims services and clinical management. Site describes the company, its services, and offers consumer information.
    • GatesMcDonald HealthPlus
      [USA, Ohio] A managed care program providing medical care via workers' compensation for injured workers. Site describes company, its services, and allows provider lookup.
    • Harvard Pilgrim Health Care
      [USA] Nonprofit organization offers HMO, PPO, and POS plans in New England. Includes benefits, coverage, financial and employment information, and health news.
    • Health Plan of Nevada
      [USA, Nevada] Offers HMO, Medicare HMO, PPO, and POS plans. Site includes information about plan options and benefits and a glossary. A subsidiary of Sierra Health Services, Inc.
    • HealthHelp
      [USA] Provides radiology management services for insurers and physicians. Its national radiology network is used by many managed care organizations.
    • HealthSpring
      [USA, Tennessee] A managed care organization in central part of state. Site describes products and services, allows provider search, and has areas for members, brokers, providers, and employers.
    • Keystone Mercy Health Plan
      [USA, Pennsylvania] Medical assistance (Medicaid) managed care health plan in the southeastern region of the state.
    • Lumenos, Inc.
      [USA] Offers three phase program of consumer-driven healthcare, consisting of health savings account, traditional health coverage, and a health toolkit.
    • Medical Network One
      [USA, Michigan] A for-profit organization committed to providing administrative services to physicians who have entered into both risk sharing and non-risk sharing agreements with managed care organizations.
    • Molina Healthcare, Inc.
      [USA] Provides managed healthcare in California, Washington, Utah, and Michigan, to individuals covered under Medicaid and related programs. [English, Spanish, Chinese, Russian, Vietnamese, and Hmong]
    • Multimed
      [South Africa] A medical scheme administrator. Services include managed care, claims management, and risk management.
    • Pacificare Health Systems
      [USA] A managed care health insurance company providing health plans for seniors, employer groups, families, and individuals. Includes areas for brokers, employers, and health care providers. Operates in western states and Guam.
    • Profit Line
      [USA] Delivers high return, risk free managed care claim audit and recovery services to the managed healthcare industry.
    • Prospect Medical
      [USA, California] An affiliation of several managed care plans in the Greater Los Angeles area who have joined together to provide the full range of medical services to patients.
    • Ravenswood Physician Associates (RPA)
      [USA, Illinois] An independent physicians association (IPA) of nearly 250 private practice physicians in Chicago and select norther suburbs. Providing insurance contract management and quality healthcare.
    • Resolution Health Medical Scheme
      [South Africa] Provides comprehensive, affordable medical cover to employer groups and individuals, and is supported by sound financial, administrative and medical controls.
    • Spectrum Managed Care
      [USA, Texas] A workers' compensation managed care firm offering claims and case management, occupational networks, and medical bill and utilization review.
    • Welsh Mountain Medical and Dental Center (WMMDC)
      [USA, Pennsylvania] A primary care center serving everyone in Lancaster County. Offering programs to serve uninsured and low-income individual and families.
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