Module 3 - CaseMANAGED CARE, ACCOUNTABLE CARE ORGANIZATIONS, HEALTH CARE CONSUMER PLANS/MODELSAssignment OverviewThere are various types of plans consumers can select. MCOs, HMOs, PPOs, POSs, or ACOs are the most common ones; however they all supply various benefits and drawbacks. Consumers (patients) have the right to choose the type of plan that best fits their needs. As a health care leader, it is vital that you understand the differences in these plans. In addition, in a health care environment where there are plenty of options for consumers (e.g., providers, medical offices, location, consumer plans etc.), ideally making the “choice” is left up to the consumer’s determination.Case AssignmentFor the Module 3 Case Assignment, conduct additional research as needed and complete the following:Part 1 – Comparative Chart: Prepare a detailed comparative chart (see example at the following source: https://philsblogspace.files.wordpress.com/2012/10/eco-chart.jpg?w=1400). In your comparative chart, evaluate and discuss the key features, differences, and disadvantages between MCOs, HMOs, PPOs, POSs, and ACOs.Part 2 – Designed an Application (App): In the world of technology, the “consumer choice” is often swayed by their research efforts or applications. In at least 2 pages, design an app to assist consumers with making a choice between the various consumer plans. Be creative and detailed about your application. Explain the contents of the application that you create and why you feel it would be beneficial to consumers.In your scholarly paper, you should include an introduction and conclusion paragraph.Assignment ExpectationsConduct additional research to gather sufficient information to justify/support your thoughts and analysis.Limit your response to a maximum of 4 pages.Support your report with peer-reviewed articles, with at least 3 references. Use the following link for additional information on how to recognize peer-reviewed journals. Angelo State University Library (n.d.) Library guide: How to recognize peer reviewed (refereed journals). Retrieved from: https://www.angelo.edu/services/library/handouts/peerrev.phpYou may use the following source to assist in formatting your assignment. Purdue Online Writing Lab. (n.d.). General APA guidelines. Retrieved from: https://owl.english.purdue.edu/owl/resource/560/01/.For additional information on reliability of sources review the following source. Georgetown University Library (n.d.) Evaluating internet resources. Retrieved from https://www.library.georgetown.edu/tutorials/research-guides/evaluating-internet-contentModule 3 - HomeMANAGED CARE, ACCOUNTABLE CARE ORGANIZATIONS, HEALTH CARE CONSUMER PLANS/MODELSModular Learning OutcomesUpon successful completion of this module, the student will be able to satisfy the following outcomes:CaseEvaluate and describe key features of CDHPs, MCOs, HMOs, PPOs, POSs, and ACOs.SLPDistinguish characteristics for successful business operations/administrations and apply appropriate health care models.DiscussionAssess a health insurance plan and propose recommendations for improvement.Module OverviewManaged Care Organization (MCOs)An MCO is a type of health care system that links health insurance with care delivery for a defined population. An MCO delivers health care through a network of providers, determines the prices for services, coordinates care, and manages appropriate use of health care services. One of the goals of the MCO is to provide the highest quality of care within the limits of available resources.Health Maintenance Organization (HMO) — Closed Panel HMOKey features: Contract with physicians and physician groups on an exclusive basis.Physicians do not see patients from other HMOs.Patients need to select a PCP and require a referral for specialty care.Highest restriction for access. No payment for outside network providers if services are rendered outside of HMO network.Two Types: Staff Model: Physicians are salaried employees of HMO.HMO owns hospitals and other health care facilities.Hospitals and facilities open to HMO members only (in principle).Group Model: Contracts with a single medical group for services.Physicians employed by the medical group, not the HMO.The medical group practices with the HMO only.Health Maintenance Organization (HMO) — Open Panel HMOKey features:Contracts with independent physicians.Physicians see patients in the physician's own office.Physicians can see patients from other HMO’s.Patients need to select a PCP and require a referral for specialty care.Two types:Network Model:Contracts with multiple medical groups or independent delivery network (IDN).IPA ModelContracts with an independent physician or physician associations.Providers paid on a discounted fee schedule or capitation.High volume of patients.Preferred Provider Organization (PPO)Key features: Contracts with independent physicians and hospitals as "preferred" network.Physicians see patients in the physician's own office and are paid with a negotiated fee.Patients do not need a PCP and no referral is needed for specialty care.The least restrictive MCO plan.Point of Service (POS)Key features: Between HMO and PPO.Members need a PCP and referral for specialty care with HMO benefits.Members can go outside of network for services (with a higher deductible and co-payments).ACOsAccording to the National Accountable Care Organization Summit (n.d.), ACOs are provider collaborations that support the integration of groups of physicians, hospitals, and other providers in different ways around the opportunity to receive additional payments by achieving continually advancing patient-focused quality targets and demonstrating real reductions in overall spending growth for their defined patient population. The ACO model is highly flexible and can be organized in several ways—ranging from fully integrated delivery systems to networked models within which physicians in small office practices can work effectively together to improve quality, coordinate care, and reduce costs. According to Shortell, Casalino, and Fisher (2010), there are at least five different types of practice arrangements that could serve as ACOs:integrated or organized delivery systemmultispecialty group practicesphysician-hospital organizationsindependent practice associations“virtual” physician organizations,Burton, D. (2014). What Is an ACO? Definitive Guide: Accountable Care Organizations. Retrieved from www.healthcatalyst.com/what-is-an-ACO-definitive-guide-accountable-care-organizations.National Accountable Care Organization Summit. (n.d.). What is an ACO? Retrieved from http://www.acosummit.com/past2011/overview.htmlShortell, S. M., Casalino, L. P. & Fisher. E. S. (2010). How the Center for Medicare and Medicaid Innovation should test Accountable Care Organizations. Health Affairs, 29 (7), 1293-1298.

The Global Burden of Disease study is conducted by the Institute for Health Metrics and Evaluation and published in the Lancet journal. It captures and analyzes data on many major causes of mortality and morbidity from almost every country. The study allows researchers and practices to compare countries and also help individual countries prioritize major health issues and risk factors with available resources. Review the background of the study by exploring the Institute for Health Metrics and Evaluation website as well as the various GBD reports found in the Lancet journal. Create a PowerPoint presentation (five to seven slides, not including your title or references slide) that addresses one of the top five causes of mortality and morbidity from the Global Burden of Disease Study (GBD). Select the health issue based on a specific country of interest and include the following in your presentation: Evidence and statistics supporting it as a major health issue, such as the Disability Adjusted Life Years or other measures of mortality and morbidity. Indicate which country you selected. Four major risk factors related to the health issue. Potential gaps or limitations in the data. Three social or economic opportunities to control or reduce the prevalence of this issue (reference the connection to the United Nations' Sustainable Development Goals). https://apastyle.apa.org/learn/quick-guide-on-refe... Read Chapter 11 in For the Love of God: Principles and Practice of Compassion in Missions. URL: http://www.gcumedia.com/digital-resources/wipf-and-stock/2017/for-the-love-of-god_principles-and-practice-of-compassion-in-missions_1e.php Explore the Sustainable Development Goals (SDGs) page of the United Nations website. Study all 17 goals in preparation for a discussion question in this topic. URL: http://www.un.org/sustainabledevelopment/sustainable-development-goals/ Explore the Institute for Health Metrics and Evaluation website. URL: http://www.healthdata.org/ Explore the Data Repository on the Global Health Observatory (GHO) page of the World Health Organization (WHO) website. URL: http://www.who.int/gho/database/en/ Explore the Health Data Tools and Statistics page of the Partners in Information Access for the Public Health Workforce website. URL: https://phpartners.org/health_stats.html Explore the Global Burden of Disease page, located on The Lancet website. URL: http://www.thelancet.com/gbd Read "The Lazy Person's Guide to Saving the World," located on the United Nations website. URL: http://www.un.org/sustainabledevelopment/takeaction/ Watch "Chris Murray and the Global Burden of Disease," by Gates (2015), located on the YouTube website. URL: https://www.youtube.com/watch?v=I_kfOygmfxA Watch "Causes of Death: Global Burden of Disease Study 2015," by The Lancet TV (2016), located on the YouTube website. URL: https://www.youtube.com/watch?v=ERvFgjBHizo Watch "What Does a $100 Million Public Health Data Revolution Look Like?" by TEDMED (2013), located on the YouTube website. URL: https://www.youtube.com/watch?v=mususV-jMFk Watch "The State of Global Health," by Global Health With Greg Martin (2013), located on the YouTube website. URL: https://www.youtube.com/watch?v=n4mz5r6KiYo Watch, "The DALY Show, Disability Adjusted Life Years (DALY)," by Kahn (Philip R. Lee Institute for Health Policy Studies) (2014), located on the YouTube website. URL: https://www.youtube.com/watch?v=Exce4gy7aOk Explore "Global: Both Sexes, All Ages, 2016, DALYs, " located on the GBD Compare/Viz Hub page of the Institute for Health Metrics and Evaluation website. URL: https://vizhub.healthdata.org/gbd-compare/ References American Psychological Association. Publication Manual of the American Psychological Association (7th Ed.). Washington, DC: Author.

To complete the assignment for this week, download the instructions by clicking on Non-Academic Distractors Template downloadand saving the file to your computer or flash drive. Then, complete the assignment, save your work, and submit the file -- with your saved changes -- to the drop box as an attachment. Be sure to submit a PDF or Word document for all Dropbox Assignments. No icloud links will be acceptable.