generate, designate, Organize, investigate and, present a Manage Care Control Cost Plan: Under traditional indemnity insurance, the money follows the patient. Patients select health care providers and visit them as they choose. Providers then bill the private insurer or public payer and are reimbursed on a fee-for-service or per case basis
. Introduction (30%) Provide a short-lived outline of the meaning (not a description) of Chapter 9 and 10 and articles you read, in your own words. Types and classifications of managed care models.
2. Manage Care Control Cost Plan: (50%)
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a. Cost savings
‘‘Structural changes centered around the expansion of managed care have been the major transformative force in health markets in recent years and have played a major role in restraining growth in health spending’’
b. Provider reimbursement
This complaint has two dimensions: hospital profitability, and physician compensation. As far as hospitals are concerned, administrators are worried about profitability or surplus for reinvestment, and consumers are worried about the threat of hospital closures. Few things stir as much public outcry as the prospect of closing a community hospital.
c. Quality of care
Much recent legislation and many legal reforms havebeen aimed at preventing managed care’s perceivedquality abuses. The Patient Bill of Rights, which hasbeen heavily debated in Congress, defines, amongother things, the rights of consumers with complexconditions to access directly a qualified specialist,continuity of provider for patients who are underregular treatment, and self-referral to certain types ofspecialists.
3. Conclusion (20%)
Quickly recapitulate your thoughts & statement to your critique of the articles and Chapter you read. How did these articles and Chapters impact your thoughts about Manage Care? What did you learn about manage care and how you will apply all these knowledge?
Evaluation will be based on how clearly you respond to the above, in particular:
a) The precision with which you analyses the articles;
b) The complexity, possibility, and organization of your paper; and,
c) Your conclusions, including a description of the impact of these articles and Chapters on any Health Care Setting.