Developing a managed care organization


Assignment:

Part 1

Within the Discussion Board area, write 300 to 500 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.

You are the chief financial officer (CFO) of a home health corporation. You have been asked by the board of directors to develop an overview of the cost reimbursement available from private, state, and federal agencies for high-technology home care being delivered to the corporation's current patients. Discuss the following:

  • Investigate and predict what impact the baby boomers will have on this issue (including the understanding that since 2011 more than 10,000 people are applying for and receiving Medicare each month).

Part 2

Your health care organization has decided to undergo a major restructuring to better align with the new Patient Protection and Affordable Care Act (PPACA) of 2010. You have been tasked with developing a managed care organization (MCO) and health maintenance organization (HMO) that will have as its core mission the ethical treatment of patients in their health care needs. Discuss the following in a double-spaced paper of 3 to 4 pages:

  • Define and propose what structure your MCO/HMO will use to maximize the ethical delivery of health care to your patients.
  • Research the library and other resources detailing best practices in MCO/HMO structuring to defend your answer.

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Business Law and Ethics: Developing a managed care organization
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