What is a managed care organization?

A managed care organization (MCO) is a health care provider or group of medical service providers that contracts with insurers or self-insured employers to provide a wide variety of managed health care services to enrolled workers through participating panel providers. The Department of Consumer and Business Services (DCBS) director must certify these organizations. The director cannot certify an organization that is formed, owned, or operated by a nonqualifying employer.

MCO services

MCO panel size and composition

MCO reporting requirements