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Health Medical

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You have been presented an outstanding opportunity to serve as a graduate student intern for the chief executive officer (CEO) of a large HCO. The HCO is an HMO model and originated approximately a century ago as a small rural hospital. Due to the rural setting, the HMO model flourished and, over the years, expanded throughout the region. Today, the HMO has a presence in over eighteen counties and has a number of competing interests from for-profit and not-for-profit HCOs in the region.

The board of directors recently approved the acquisition of two regional hospitals. First, the HCO decided to acquire a small rural critical-care-access hospital in a relatively remote county. The interest in acquiring the hospital is to service the existing population and expand the reach of the HMO. Second, the HCO decided to acquire a private full-service hospital in a moderate-size city (population forty-two thousand). The HCO’s move is strategic in nature, preventing the sale of the hospital to its for-profit competitor, and will gain the region its sole emergency department level 2 (two) trauma center with helicopter transport while giving the HCO the ability to service its growing HMO membership in the area.

Based on the above information:

  • Evaluate the various HMO models (staff, group, and network) and identify the model that would probably be best suited for the region. Justify your answer.
  • Research and comment on the importance and applicability of the various levels of emergency department trauma care. Investigate the exemptions afforded to a critical care rural hospital with respect to Medicare reimbursement and accreditation.
  • Elaborate on the difference between an HMO and an accountable care organization (ACO).
  • Explain the concept of capitation, its importance to the HMO and participating providers, and how the concept of capitation varies with the ACO model.
  • Explain patient-centered care and its importance in healthcare delivery.

The following resources are provided for this assignment:

  1. American Trauma Society, (2017). Trauma center levels explained. Retrieved from: http://www.amtrauma.org/?page=traumalevels
  2. American College of Surgeons. (2017). Verified trauma centers FAQ’s. Retrieved from: https://www.facs.org/quality%20programs/trauma/vrc...

To support your work, use other textbook readings. As in all assignments, cite your sources in your work and provide references for the citations in APA format.

  • Your assignment should be addressed in a 3-page document.

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Explanation & Answer

Hello,Here you go, kindly check it out and let me know in case of any revision. Feel free to invite me for more questionsRegards

Running head: HEALTH MAINTENANCE ORGANIZATIONS

Health Maintenance Organizations
Name
Institution Affiliation

1

HEALTH MAINTENANCE ORGANIZATIONS

2

Health Maintenance Organizations
The opportunity as an intern Chief Executive Officer requires proper strategic
management skills essential in promoting and enhancing elements of being a competitive
advantage in health care. Further, developing new leadership skills will enable employee
commitment to achieve a higher performance for the company as well as understanding the risks
encountered and models to counter them. As a result, it is essential to understand the nature of
the organizational culture before implementing any changes that do not much since it is vital for
the cooperation of the activities in the company. Therefore, it is imperative to determine the
various HMO models that can be suitable for the region selected for expansion, the need for
applying different levels in a departmental emergency of trauma care. Similarly, it is crucial to
explain the difference between the accountable care organization and HMO as well as the
concept of capitation.
Evaluation of HMO models
Primarily, various HMO models can be practiced by the company in the selected region
which are suitable for obtaining the best results. The group model of HMO is one of the best
models to consider for the chosen area si...


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