Colorado College Health Care & Human Resource Management Discussions

User Generated

Ohex

Health Medical

Colorado College

Description

Please complete all parts

Part 1

Within the Discussion Board area, write 250-350 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas.

Using the Beyond the Book resource and online and digital resources, discuss different types of models for managed care. Address the following:

  • Discuss at least 1 reason why the managed care delivery model was created.
  • Describe at least 2 different types of managed care, including their differences.
  • Identify at least 1 advantage and 1 disadvantage of the managed care model.

Part 2

Within the Discussion Board area, write 250-350 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas.

How healthcare services are provided is constantly changing. While historically, emergency departments (ED) was physically located within the hospital building, the standalone Emergency Department also referred to as the Free Standing Emergency Department (FSED) has become a new model for delivery of emergency services within communities. Consider yourself in the role of a consultant to a healthcare organization, financial manager, or ED administrative director. You have been asked to provide the CEO and leadership with pros and cons of establishing a Free Standing Emergency Department. You are aware of the news stories about these types of facilities, and you will want to review The Washington Post article at this link as you prepare your review.

Include in your discussion:

  • Differences between off campus emergency departments (OCEDs) and independent free standing emergency centers (IFECs). What would be the advantage to the healthcare organization of an OCED?
  • How would services provided be reimbursed either by private insurance or Medicare/Medicaid?
  • What are the advantages or disadvantages to the community of an FSED? Would members of the community favor an OCED or an IFEC?
  • Why are most of the FSEDs located in Texas, Colorado and Ohio?
  • Based on your research and the news stories about FSEDs, what would you recommend to the CEO and Board of Directors?

NOTE: Use at least two scholarly references and cite using APA format.

Part 3

Within the Discussion Board area, write 250-350 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas.

Physicians and other providers of clinical care play a key role in delivery of healthcare. With the various models of reimbursement and goals of cost containment, the role of the physician in managing patient care has changed.

  • Describe two reimbursement models and the role of the physician in each model.
  • How do government and private insurers influence how physicians practice today?
  • Why is accurate and complete documentation in the electronic health record important to reimbursement and quality of care?
  • What other members of the healthcare team who do not provide direct care to patients contribute to cost containment and delivery of healthcare services

NOTE: Use at least two scholarly references and cite using APA format.

Part 4

Review and reflect on the knowledge you have gained from this course. Based on your review and reflection, write at least 3 paragraphs on the following:

  • Identify one challenge you see in the U.S. health care system today. What healthcare organizations/departments are impacted?
  • Identify one government agency and its role in meeting the challenge?
  • Considering your career goals in the healthcare industry, how would your role as a member of the healthcare team and your team be involved in meeting the challenge?
  • What did you learn in this course that was most surprising or unexpected from when you started the course?

User generated content is uploaded by users for the purposes of learning and should be used following Studypool's honor code & terms of service.

Explanation & Answer

Attached.

Running Head: CRB HEALTHCARE DISCUSSIONS

CRB Healthcare Discussions
Student’s Name
Institute Affiliation

CRB HEALTHCARE DISCUSSIONS

2
Part 1

The reason for establishing the managed care delivery was to minimize the medical cost in
hospitals, by regulating both the type of services provided and maintain the quality care.
The two types of managed care plan include a preferred Provider Organization (PPO) and
Health Maintenance Organization (HMO (Araujo, 2019). The HMO tends to help the employers
find a way in which they can help their employees with healthcare needs. This is achieved by
minimizing the costs through negotiation with clinics, specific doctors, and hospitals. Sometimes
any medical facilities can be used primarily on an emergency or when there is a necessity to use
them. Members of this organization pay a fixed amount of fee every month is known as premium.
It is less expensive compared to other managed plans. The type of services provided usually
determined by the policy.
The preferred Provider Organization (PPO), provide reduced costs to individuals
recognized in their health insurance plan (Araujo, 2019). The organization is similar to the HMO,
but the members or the employees in this organization have the right to choose the medical doctor
they would like to see. Members also pay a fixed amount of money monthly and also co-payments.
Besides, the members can select a provider who can be a member or a nonmember.
The benefit of the managed care model is the provision of health care solutions to
individuals who seek help from medical providers (Ayres, 2019). Immediate services can be
provided to the individual with a considerable level of conviction. The major disadvantage of the
managed care model is that it restricts care access to those people who do not have provider
coverage or insurance.

CRB HEALTHCARE DISCUSSIONS

3
Part 2

The freestanding emergency department aims at providing improved quality c...


Anonymous
Really helped me to better understand my coursework. Super recommended.

Studypool
4.7
Trustpilot
4.5
Sitejabber
4.4

Similar Content

Related Tags