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Pages:
1 page/≈275 words
Sources:
2 Sources
Style:
APA
Subject:
Health, Medicine, Nursing
Type:
Research Paper
Language:
English (U.S.)
Document:
MS Word
Date:
Total cost:
$ 5.18
Topic:

Risk Management and The Roles of Managed Care

Research Paper Instructions:

Assessment Description
The purpose of this assignment is to analyze the role of managed care organizations within health care and risk management programs.
Reflect on and evaluate the role that the managed care organization (MCO) plays in today's health care environment by developing a 250‐500-word response that addresses the following:
What is a health care organization's administrative role in executing risk management policies and ensuring compliance with managed care organization (MCO) standards?
What value do the regulatory statutes of a typical MCO provide to a health care organization? Consider how strategies pertaining to policies such as conflict resolution and risk management affect patients as well as employees and employers.
What MCO responsibilities relevant to the Patient Protection and Affordable Care Act (ACA) and Center for Medicare and Medicaid Services (CMS) focus on fraud, waste, and abuse laws?
In addition to your textbook, you are required to support your analysis with a minimum of two peer‐reviewed references.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
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 LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Assessment Description
The purpose of this assignment is to analyze the role of managed care organizations within health care and risk management programs.
Reflect on and evaluate the role that the managed care organization (MCO) plays in today's health care environment by developing a 250‐500-word response that addresses the following:
What is a health care organization's administrative role in executing risk management policies and ensuring compliance with managed care organization (MCO) standards?
What value do the regulatory statutes of a typical MCO provide to a health care organization? Consider how strategies pertaining to policies such as conflict resolution and risk management affect patients as well as employees and employers.
What MCO responsibilities relevant to the Patient Protection and Affordable Care Act (ACA) and Center for Medicare and Medicaid Services (CMS) focus on fraud, waste, and abuse laws?
In addition to your textbook, you are required to support your analysis with a minimum of two peer‐reviewed references.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
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 LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Assessment Description
The purpose of this assignment is to analyze the role of managed care organizations within health care and risk management programs.
APA formatting guidelines, which can be found in the APA 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 not required to submit this assignment to LopesWrite.
Reflective Analysis: Risk Management and the Role of Managed Care

Research Paper Sample Content Preview:

Risk Management and the Roles of Managed Care
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Risk Management and the Roles of Managed Care
The main administrative role in executing risk management policies and ensuring compliance with MCO standards is controlling the demand and supply of healthcare resources. Cahill (n.d.) noted that the overall costs are controlled by managing the demand and supply of healthcare resources. Another administrative role is the proper management of information, which is to ensure their integrity and completeness as well as allow access as per the law (Pozgar, 2013). Such roles ensure financial risks are managed well.
The regulatory statutes of a typical MCO have immense value to organizations’ healthcare. One of such statutes is the quality strategy that requires states to maintain a strategy whose aim is to measure and improve the quality of healthcare services provided by MCOs (MACPAC, n.d.). In this case, a healthcare organization can have a benchmark to use in setting targets and assessing its provision of care and services.
Strategies related to conflict resolution and risk management policies affect key stakeholders like patie...
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