Risk Management and the Role of Manage Care Organization

Reflective Analysis – Risk Management and the Role of Managed Care
Your Name
Subject and Section
Professor’s Name
May 27, 2019
Managing a healthcare organization effectively is important in order to ensure the quality and effectivity of the provision of healthcare. However, despite the crucial nature of the role of managers, the day-to-day functions within the organization pose a great challenge due to different factors, both internal and external of the organization. This includes factors ranging from the very performance of the employees and until the cost of healthcare treatments that affects the patient’s capacity to avail them. In line with this, many strategies have been developed in order to ensure that healthcare treatments would become easily available and accessible to anyone. One of such strategies includes the establishments of Managed Care Organizations (MCOs), who are tasked to deliver “Medicaid Healthcare Programs” (Meltzer, 2018). Due to the nature of such organizations, they must always exert the due diligence needed in order to develop risk management strategies and ensure compliance among their employees. For example, in order to make sure that risk-management strategies are adequately met, the HCOs must always ensure that they are adequately and effectively staffed. This means that MCOs, must not only have the right quantity, but also the right personnel for the specific needs of their patients (The National Academies Press, n.d.).
Aside from its oversight functions, MCOs must also make sure that their performance is satisfactory for their patients. It is not enough that MCOs comply with the provided regulations, but they must always consider patient experience and satisfaction among others. This would not only benefit the patient themselves, but also the healthcare organization as a whole for better patient satisfaction would also provide better incentives for the healthcare provider under the Medicare’s Hospital Value-Based Purchasing Program (Blake, 2016). However, ensuring patient satisfaction means that effective measures are in place so that MCOs can gauge whether they are reaching thei...