Risk Management & The Role of Managed Care

Risk Management & The Role of Managed Care

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Risk Management & The Role of Managed Care

Question Description
Help me study for my Nursing class. I’m stuck and don’t understand.

PART A- Discussion Questions due by Wednesday
DQ 1 – WATCH VIDEO Plus add x1 reference

Risk Management & The Role of Managed Care – Nurses Homework | Nurses Homework

Health care organizations continually face challenges from various regulatory and government agencies while also being bound by Managed Care Organization (MCO) standards. View the video located in the study materials entitled “College of Nursing and Health Care Professions: Do We Know What Our Future Is?” for insight into the challenges of health care reform. Based on the video, describe two key reform factors that you believe will need to be addressed by future health care workers or leaders and explain why. (Note: You can download slides from this video for ease of review in developing your forum response). Additionally, what role does adherence to MCO standards play in your future health care vision? (250 words response plus x1 peer reviewed source to support response )

Video link:

Watch the video “College of Nursing and Health Care Professionals: Do We Know What Our Future Is?”

URL:

http://lc.gcumedia.com/zwebassets/courseMaterialPages/nur508_healthcare-reform-video-series-v1.1.php

DQ2- Research with x2 sources- peer reviewed articles

The Affordable Care Act (ACA) identifies requirements related to provider compliance with fraud, waste, and abuse laws that have been enacted to protect consumers. (250 words response) Research three of these requirements and describe the corresponding measures that your health care organization has initiated, or could initiate, to comply with the ACA. Support your analysis with a minimum of two peer-reviewed articles.

PART B -Assignments Due by Fr
Assignment #1 – Paper

Title: Reflective Analysis- Risk Management & The Role of Managed Care

The purpose of this assignment is to analyze the role of managed care organizations within health care and risk management programs.

Reflect on and evaluate the role that the managed care organization (MCO) plays in today’s health care environment by developing a 250‐500-word response that addresses the following:

1.What is a health care organization’s administrative role in executing risk management policies and ensuring compliance with managed care organization (MCO) standards?

2.What value do the regulatory statutes of a typical MCO provide to a health care organization? Consider how strategies pertaining to policies such as conflict resolution and risk management affect patients as well as employees and employers.

3.What MCO responsibilities relevant to the Patient Protection and Affordable Care Act (ACA) and Center for Medicare and Medicaid Services (CMS) focus on fraud, waste, and abuse laws?

Required sources from: textbook (Read Chapters 18, 19, and 26 in Legal and Ethical Essentials of Health Care Administration.And you are required to support your analysis with a minimum of two peer‐reviewed references.

Prepare this assignment according to the guidelines found in the APA Style. An abstract is not required.

This assignment uses a rubric (see attached doc titled Assignment Paper Rubrics). Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Assignment #2 – PowerPoint presentation

The purpose of this assignment is to create an educational risk management presentation.

SEE ATTACHED DOCUMENT WITH PART 1 OUTLINE AND INSTRUCTOR FEEDBACK AT THE BOTTOM OF THAT OUTLINE COLORED IN BLUE.

USE POWERPOINT TEMPLATE SENT AS SEPARATE ATTACHMENT

Building upon the outline for an educational session you created in the Educational Program on Risk Management Part One: Outline of Topic 2 assignment, develop a 12-15 slide PowerPoint presentation that expands in greater detail on how and why your organization should implement your proposed risk management strategy. Incorporate any instructor feedback from the Topic 2 assignment into this presentation and include talking points in the speaker notes section of each slide.

Keep in mind that the PowerPoint is meant to serve as a visual aide to bolster your presentation and is intended to highlight main ideas and key points. Do not use dense blocks of text or more than 7 bullet points of text per slide. However, you may include supplementary images, graphs, and data where relevant.

To successfully complete this assignment, include the following sections as per your outline from Topic 2, though you may include any additional sections as needed:

1.Introduction

2.Rationale

3.Support

4.Implementation

5.Challenges

6.Evaluation

7.Opportunities

You are required to support your statements with a minimum of six citations from appropriate credible sources.(same as outline in part 1)

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting

This assignment uses a rubric (see attached doc titled-“PowerPoint Rubic”) for Rubics. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.