The national voice of managed care. 

CMCA is dedicated to the promotion of ethical practices between health care providers and payors of health services and benefits. It is an essential component of protecting and preserving the financial security of health care in Canada. CMCA is a federally run, not-for-profit association that contributes to the integration of health care by licensing its proprietary network of contracted practitioners, suggested program guidelines, and schedule of services under reference-based pricing (RBP) to payors of health care and benefits (plan sponsors). Contracted practitioners perform services under a PPN delivery of care model that adheres to recommended and suggested program guidelines and schedules of services that meet the better business practices of the providers’ professional associations and governing bodies. This model produces savings of 20-30% on all claimed services for payors. Payors are now able to produce savings, that enables funding, to improve and re-introduce back into health care ultimately improving the wellbeing of their members/employees. 

Contracted practitioners enrolling in the CMCA’s network become members as they accept the Suggested Program Guidelines accompanied by their Schedules of Health and Dental Services under RBP. Program Guidelines and the Schedule of Health and Dental Services under RBP are consistent with each practitioner’s discipline and/or scope of practice.

The CMCA becomes the licensor of its practitioner network as it licenses it out to its management umbrella, First Canadian Benefits (FCB). FCB’s Procurement Committee is responsible for entering into contracts and agreements with payors seeking cost containment for their employee benefits offerings. All agreements and dispute resolutions are reviewed and accepted under governance by a panel of board members representing the CMCA’s territorial bodies. Example: Ontario Managed Care Association (OMCA). 

The CMCA’s proprietary network, suggested program guidelines, and its schedule of health and dental services under RBP is away from common ownership and is a not-for-profit care model. It organizes health care by facilitating changes and renewing the social contract to maintain its professional status. Making necessary reforms to preserve the economic viability of health care under institutional ethics and jurisprudence.