Question

Explain how quality can be monitored in HMO and Medicare?

Answer 1

HMO and Medicare are the health insurance providing organization.Here the individual who is in need of health insurance want to pay a prescribed premium for a period of time.Over a period of time suppose if the individual affected by any health problem for that he admitted in hospital for treatment.To manage the cost and to pay the bills he can claim his insurance plan.That is the activity between the insurance organization and the customers.So here what are the quality measures.Quality should be look over through the factors such as customer satisfaction, coverage of health services,Human resource development and overall services.These are the areas where the quality can be measured.It can measured in any following ways such as feedback from customer,conduction of internal and external audit and through checklist or other measuring scales.Through this the quality can be measured.To improve quality the organization should always have a proper organizational structure and all the employees should know the vision and mission of the organization,norms of the institution so that the care delivered will have quality.