The diversity of MCOs is more obvious if they are seen as multidimensional
arrays, with each dimension corresponding to a different legal or economic
parameter. The first dimension in describing MCOs is the interests of the
controlling entity, characterized in the following listing.
Insurers: An insurance company owns the MCO and uses it to provide
care for its insured lives.
Hospitals: The MCO is used to ensure that patients occupy beds and to
increase leverage with insurers who pay for the care of the patients.
Physicians: The MCO, often called a network, is formed by a group of
physicians to increase their bargaining power with insurers and hospitals.
Brokers: An MCO that is formed as a business venture by investors other
than physicians, hospitals, or insurers.
Governmental: Most governmental clinics are MCOs. The Veterans
Administration hospital system, for example, has been an MCO for years.