Managed Care V (Project)

Current Trends and Issues in Managed Care

Compensation and reimbursement models are another method of controlling access, cost, and quality in a managed care environment. An MCO doesn’t have direct control over physicians or hospitals but through contractual agreements that set incentives for meeting agreed-upon standards, it can exert influence.

This week, you are required to write an essay on the following topics:

• Managed care hospital reimbursement
• Managed care provider reimbursement

Using the Online library (e.g. CINAHL) or the Internet, review at least two articles for each topic and write a review for each source of information. Use the following guidelines for developing your essay:  Use at least 3 credible resources for the assignment, including at least 1 scholarly peer-reviewed resource.

• Write a summary for each topic tying together the information learned about that topic.
• Analyze the market forces that would favor using one reimbursement method over another.
• Evaluate the key differences between different types of payment methodologies from the provider and hospital point of view.
• Evaluate the advantages and disadvantages of the payment methodologies reviewed from the provider and hospital point of view.
• Evaluate new payment methodologies resulting from the Patient Protection and Affordable Care Act (PPACA) and discuss future changes in reimbursement methodologies.
• Compare and contrast each article to the information discussed in the course textbook.

This paper should be formatted in APA and be 3-5 pages in length without a cover and reference page. Include and introduction and conclusion in your paper. See Project rubric for requirements