Assignment: Managed Care Organizations

Assignment: Managed Care Organizations
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Assignment: Managed Care Organizations
To better coordinate care, many hospitals have initiated a physician–hospital orga- nization (PHO), a joint venture capable of contracting with managed care organizations. Both integrated delivery systems and the more recent physician–hospital organizations have had limited success in coordinating and integrating healthcare.
In 2005, MedPAC reported that future government reimbursement for health services should be based on four criteria—one of which was high-quality, cost-effective care (MedPAC 2005). In 2006, President George W. Bush signed an executive order asking federally sponsored health plans, including Medicare, to adopt the four criteria. The concept of an accountable care organization (ACO), which emphasizes coordinated care and
integrated delivery
mandates provider accountability, was born in 2007 (Fisher et al. 2007). The ACO concept includes financial incentives for organizations that take responsibility for the quality and cost of patient care to a defined population. In 2009, MedPAC recommended that Medicare encourage the development of ACOs, and Section 3022 of the Affordable Care Act of 2010 encouraged the voluntary development of ACOs (Tuma 2010). By the end of 2015, 838 ACOs existed (Muhlestein and McClellan 2016).
IntroductIon Financial analysis and management reporting are integral parts of the management func- tions of control and financial management. Financial analysis includes methods used by investors, creditors, and management to evaluate the past, present, and future financial performance of a healthcare organization. On completion of the analysis, the information is reported to the appropriate stakeholders, inside and outside the organization, at which time the stakeholders take action in the form of decisions.
stePs In fInAncIAl AnAlysIs Financial analysis includes the following three steps:
1. Establish the facts about the organization.
2. Compare the facts about the organization over time and with facts about similar organizations.
3. Use perspective and judgment to make decisions regarding the comparisons.
Financial analysis by management can occur at any level—departmental, divisional, or organizational—within the organization.
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.
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