Role of MCO in today’s healthcare environment

Role of MCO in today’s healthcare environment

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Role of MCO in today’s healthcare environment

Question Description
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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:

What is a health care organization’s administrative role in executing risk management policies and ensuring compliance with managed care organization (MCO) standards?
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.
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?
In addition to your textbook, 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 Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Read “The Health Care Fraud and Abuse Control Program Protects Consumers and Taxpayers by Combating Health Care Fraud,” from the CMS Newsroom (2016), located on the U.S. Centers for Medicare and Medicaid Services (CMS) website.

URL:

Role of MCO in today’s healthcare environment – Nurses Homework | Nurses Homework

https://www.cms.gov/newsroom/fact-sheets/health-care-fraud-and-abuse-control-program-protects-consumers-and-taxpayers-combating-health-care

Read “Assessing Changes to Medicaid Managed Care Regulations: Facilitating Integration of Physical and Behavioral Health Care,” by Edwards (2017), located on The Commonwealth Fund website.

URL:

https://www.commonwealthfund.org/publications/issue-briefs/2017/oct/assessing-changes-medicaid-managed-care-regulations-facilitating

View the presentation “EMTALA: A Shifting Landscape,” located on the American Bar Association (ABA) website.

URL:

https://www.americanbar.org/content/dam/aba/administrative/healthlaw/EMTALA_4_10_18.authcheckdam.pdf

 

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.