Certified Revenue Cycle Representative (CRCR) Practice Exam

Why do managed care plans establish agreements with healthcare providers?

1. To minimize paperwork for billing

2. To increase the number of patients

3. To improve access to quality healthcare

4. To control costs for medical supplies

The correct answer is: To improve access to quality healthcare

Managed care plans establish agreements with healthcare providers primarily to improve access to quality healthcare. By forming partnerships, managed care organizations can create networks that ensure patients have a wide range of healthcare options. These agreements help streamline patient access to necessary services and specialists, thus enhancing the overall quality of care provided. Additionally, such partnerships often involve negotiated rates and care guidelines, which can further promote consistency in care delivery. By focusing on quality, managed care plans aim to achieve better health outcomes for patients, reduce unnecessary hospitalizations, and encourage preventive care practices, all of which contribute to an effective healthcare system. While other choices may touch upon aspects of managed care operations, such as administrative efficiency or cost control, the primary motivation behind the agreements is fundamentally aimed at improving patients' access to needed healthcare services.