HLT 205 Week 4 Assignment Managed Care

HLT 205 Week 4 Assignment Managed Care

Details:

The most powerful force shaping the U.S. health care delivery system is managed care. As a health care professional, it is vital that you understand the managed care system, as it impacts all stakeholders. The purpose of this assignment will be for you to demonstrate your knowledge of managed care through a PowerPoint presentation that explains the following:

An explanation of what a managed care organization (MCO) is and how MCOs

evolved.

The identification of the accrediting bodies for MCOs and an explanation of the types of care they oversee.

A description of managed care plans, such as HMOs and PPOs.

An explanation of the impact of MCOs on cost, access, and quality.

An explanation of what an accountable care organization is and its relationship to MCOs.

The PowerPoint presentation will be comprised of 10-12 slides with detailed speaker notes containing in-text citations.

Three references (minimum) in addition to your text book are required for this assignment.

While GCU style format is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using GCU documentation guidelines, which can be found in the GCU Style Guide, located in the Student Success Center.

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This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing for-profit health care and providing American health insurance while improving the quality of that care (“managed care techniques”). It has become the essentially exclusive system of delivering and receiving American health care since its implementation in the early 1980s, and has been largely unaffected by the Affordable Care Act of 2010.

…intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as Health Maintenance Organizations and Preferred Provider Organizations.[1]

The growth of managed care in the U.S. was spurred by the enactment of the Health Maintenance Organization Act of 1973. While managed care techniques were pioneered by health maintenance organizations, they are now used by a variety of private health benefit programs. Managed care is now nearly ubiquitous in the U.S, but has attracted controversy because it has had mixed results in its overall goal of controlling medical costs.[2] Proponents and critics are also sharply divided on managed care’s overall impact on U.S. health care delivery, which ranks among the best in terms of quality but among the worst with regard to access, efficiency, and equity in the developed world.[3]

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