Managed Care Organization (MCO) Law and Legal Definition

A managed care organization (MCO) is a health care provider or a group or organization of medical service providers who offers managed care health plans. It is a health organization that contracts with insurers or self-insured employers and finances and delivers health care using a specific provider network and specific services and products.

They provide a wide variety of quality and managed health care services to enrolled workers keeping medical costs down through preventative medicine, patient education, and in other ways. These organizations are certified by the director of the Department of Consumer and Business Services (DCBS).

MCOs vary in their constitution as some organizations are made of physicians, while others are combinations of physicians, hospitals, and other providers. For instance, a group practice without walls, independent practice association, management services organization, and a physician practice management company are the common MCO’s.