Get help for Ashford-University MHA 628 Homework Help. In preparing for this discussion, read Chapters 1 and 2 of the course text. • Select a managed care plan such as an HMO, PPO, POS, or EPO and discuss its advantages and disadvantages. • Explain the main features of a consumer-directed health plan (CDHP). Your initial post should be at least 300 words. Support your response with a minimum of two credible sources that were published in the last five years. Guided Response: Challenge your peers to think about the cost saving, quality, and/or access to care that a health care plan can offer. Be sure to support your response by citing at least one credible source to validate your assertions. Respond to at least two of your classmates’ posts. Carefully review the Discussion Forum Grading Rubric for the criteria that will be used to evaluate this Discussion Thread. In preparing for this discussion, read Chapter 3 of the course text as well as the required document, The Final Rule for the Medicare Shared Savings Program. • Describe the roles, functions, and liabilities of the board in a managed care organization.
• Assess the main differences regarding Governance as well as Leadership and Management Structure between the Medicare Shared Savings Program and a managed care organization. Your initial post should be at least 300 words. Support your response with a minimum of two credible sources that were published in the last five years. Guided Response: Select two roles, functions, or liabilities of the board outlined by your peers and describe their importance for a managed care organization. Be sure to support your response by citing at least one credible source to validate your assertions. Respond to at least two of your classmates’ posts. Carefully review the Discussion Forum Grading Rubric for the criteria that will be used to evaluate this Discussion Thread. 1. Question : Geisinger Clinic (GC) is an example of captive group HMO model in the Geisinger Health Plan (GHP). Which of the following is NOT true for this case scenario? Question 3. Question : As long as Independent Practice Associations (IPAs) of HMOs do not prohibit their member physicians from being able to contract directly with an HMO, antitrust statute does not regulate IPA physicians’ group activities.
Medicare HMOs on a capitated basis. Question 5. Question : Which of the following is NOT true for Preferred Provider Organizations (PPOs)? Question 6. Question : In the staff model of HMO, the physicians are paid on a salary basis only. Question 7. Question : Which of the following managed care organization has a board of directors? Question 8. Question : Which of the following is NOT a board committee in a managed care organization? Question 9. Question : Which of the following is NOT a type of integrated healthcare delivery systems (IDSs)? Question 11. Question : The final rule for the Medicare Shared Savings Program requires the ACO to be a financial entity in order to receive and distribute payments for shared savings. Question 12. Question : Which of the following is NOT true about Health Maintenance Organizations (HMOs)? Question 14. Question : Healthcare providers’ participation in accountable care organizations and patient-centered medical homes is not mandatory by the Affordable Care Act (ACA) because neither one is articulated in ACA.
In preparing for this discussion, read Chapter 5 of the course text. • Explain the pros and cons of four provider payment methods: (a) fee-for-service; (b) capitation; (c) global capitation; and (d) bundled payment. • Based upon your review on the above payment methods, what is your recommendation for the mainstream of provider payment(s)? Be sure to include a detailed account of the benefits and risks. Your initial post should be at least 300 words. Support your response with a minimum of two scholarly sources that were published in the last five years. Guided Response: Challenge your peers to think about the provider payment from quality and cost perspectives. Be sure to support your response by citing at least one scholarly source to validate your assertions. Respond to at least two of your classmates’ posts. Carefully review the Discussion Forum Grading Rubric for the criteria that will be used to evaluate this Discussion Thread. In preparing for this discussion, read Chapters 4 and 6 of the course text. • Discuss common issues in the contracting process. • Describe four provider obligations commonly included in managed care contracts.
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