Which term describes the strategy used to manage the costs and quality of healthcare services provided to members?

The concept of managed care is integral to modern healthcare delivery systems. It encompasses a variety of strategies designed to control costs while ensuring adequate quality of care for members of a health insurance plan. Managed care providers typically promote preventive care, coordinate patient services, and establish networks of healthcare providers who agree to offer services at reduced costs.

This approach encourages the efficient use of healthcare resources, ultimately aiming to keep both the financial aspects and quality of care in check. By integrating services and focusing on outcomes, managed care helps to reduce unnecessary procedures and hospitalizations, thus leading to overall reduced healthcare expenditures for both patients and insurers.

The other options represent different aspects of the healthcare payment landscape: fee-for-service is a model that pays providers for each service rendered, which can lead to increased costs without necessarily improving quality; capitation involves paying a fixed amount per member to cover all necessary services, which can incentivize providers to focus on efficiency but may risk under-provision of care; and accreditation pertains to the validation and recognition of healthcare organizations meeting specific standards, rather than focusing on the management of costs and quality for members.