Question: Consider the chapter reading on Managed Care Organization. As the manager of a Primary Care health facility you have just been informed that one of
Consider the chapter reading on Managed Care Organization. As the manager of a Primary Care health facility you have just been informed that one of the larger local employers has switched their insurance carrier over to a managed care organization specifically HMO. You will need to convey how this change will ultimately affect the facility, considering a large number of the employers are patients at the facility. In an effort to get ahead of question and/or confusion you have scheduled a staff meeting with your administrative staff to elaborate on specific topics. Properly educating the staff means that your staff can properly inform the patients. Create a power points that discuss relevant topics such as:
HMO, discuss payment, care coordination, gatekeeping, utilization review, capitation fixed amount will be $4.00 per member monthly, cost, choice restriction, practice profiling and additional other topics that YOU the manager feel will be essential.
In this PowerPoint I am NOT looking for a list of definitions only. The PowerPoint will need to flow with content and indicate that you understand Managed Care and the relationship with Integrated Organizations. Discuss the advantages and disadvantages of a Managed Care Organization, HMO etc. I will be looking for how you think this will financially impact (consider the capitation) the facility. All of the information is in your book, listed in table etc.
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