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.

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.

 

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The evolution of Managed Care organizations

Introduction

The managed care industry has grown into a huge market, with billions of dollars in revenue and thousands of employees. In this post, we’ll explore the evolution of this industry by looking at the birth of managed care organizations, their shift from indemnity and HMO insurance plans to compete with one another on price and quality, and how personalised care will change how these companies operate going forward.

The birth of managed care organizations

With the birth of managed care organizations, healthcare costs have been steadily rising for more than 50 years. In response to this trend and other factors like patient demand and regulations, MCOs have emerged as an innovative way to manage healthcare costs while still providing access to quality care.

Managed care organizations are a recent development in the history of healthcare systems; the first managed care organization was created in 1963 by retired general surgeon H.R. Haldeman (who later became Nixon’s Chief of Staff). Now known as Kaiser Permanente Federation (KPF), it was originally created for employees at Kaiser Industries plant in San Francisco California. The KPF model has since spread across multiple states throughout America including California where it currently covers over 1 million members with its network comprised primarily by hospitals but also includes physicians who contract directly with their employer rather than joining an association or professional society like those found at traditional health systems

The shift from indemnity and HMO insurance plans

The shift from indemnity and HMO insurance plans to managed care organizations is also a major development in the field of health care. This has led to an increased focus on personalised care, which includes patient-centred treatment at lower costs.

Managed care organizations offer patients access to their own physician or specialists if they choose, but can also provide more advanced technologies such as CT scans and MRIs. They also allow patients access to alternative therapies that may not be covered by traditional insurance plans

Competition heats up as buyers demand low costs and improved quality.

Managed care organizations (MCOs) are looking for ways to improve their efficiency and quality.

The health care industry is undergoing a major transformation. In the past, hospitals were the largest buyers of health care services; today, it’s primarily MCOs that are buying them. As a result, hospitals and physicians have become more focused on improving their efficiency, as well as reducing costs. They’re competing with each other to see who can provide better value at lower prices while maintaining or increasing quality levels—and they’re all competing with managed care organizations (MCOs) for market share in this new environment

Personalised care is the future of managed care organizations

Personalised care is the future of managed care organizations. It’s a key component of the health system, and it can be delivered by a range of healthcare providers. But what does it mean for you?

Personalised care means improving your experience by focusing on your specific needs and concerns at each step along the journey from diagnosis to recovery – from when you see your doctor or nurse practitioner to when you receive treatment at one of our hospitals or clinics, including home visits if necessary.

Takeaway:

• Managed care organizations are a common sight across the country.

• They’re a way to provide affordable healthcare, while also helping patients better manage their own health care needs.

• The industry has changed over time, but the core principles remain the same: it’s all about people and technology.

Conclusion

The evolution of managed care organizations is a fascinating story of competition, innovation and business growth. From being a start-up to becoming an industry leader, these companies are now managing nearly 3 billion healthcare dollars annually in the United States alone. With the rise of technology and increased competition, it seems like there is no limit on how far they can go!