Certified Specialist Payment Rep (CSPR) Practice Exam

The primary purpose of a managed care organization (MCO) is to control healthcare costs while ensuring quality care. MCOs are designed to provide a framework within which healthcare services can be delivered in a more efficient and cost-effective manner. They achieve this by coordinating care across different providers, managing patient access to services, and implementing preventive care strategies. This approach not only helps in managing expenses but also aims to maintain or improve the quality of care provided to patients.

In a managed care setting, the focus is on creating networks of providers and facilities that adhere to specific protocols and standards, which helps to streamline healthcare delivery. By emphasizing preventative care and comprehensive management of patients' health, MCOs can better manage costs over time, reducing the need for more expensive emergency care or advanced interventions that could arise without proper management.

The other options do not accurately capture the main objective of MCOs. Limiting types of services or focusing solely on emergency services would not fulfill the organization’s overarching goal of integrated, coordinated care that addresses a range of health needs within a managed cost structure. Additionally, increasing reinsurance options for providers does not align with the fundamental purpose of MCOs in managing patient care and costs effectively.