Question

5. Discuss possible ways to create a seamless regulatory system for all managed care organizations.

Answer 1

POSSIBLE WAYS TO CREATE SEAMLESS REGULATORY SYSTEMS FOR ALL MANAGED CARE ORGANISATIONS ARE BY:

• Building successful partnership with managed care plans is one of the key to create seamless regulaory systems.
• Speciality managed care behavioural health services care for the substance abuse and treatment of Mental Illness.Over past ten years integration of services of care coordination has been promised and in some cares had delivered improved results.
• Components that are involved are Multidisciplinary team approach provided under the care of Medical doctors
• Collaboration between the Specialists, Clinical doctors, Psychiatrists, Dieticians,Nurses, all other Health care team members play a key role in providing seamless care to patients.
• Providing close monitoring care of the high risk patients and providing follow up care.
• Reinforce Evidenced Based Practice in order to provide quality care of patients.

Solutions to create a seamless regulatory system for all managed care are as follows:

1. Enroll and reconcile the members accurately and easily
2. Automatically verify data of patients through connect ,direct capability
3. Receive the highest star ratings settings for high calibre care and clinical outcomes
4. Achieve and maintain compliance with new government regulation
5. Track and report on critical quality and compliance measures.
6. Deliver transparency of information for Superior customer service
7. Lower administrative costs significantly by automating work flows
8. Leverage key data sources with seamless integration.

All managed care organisations

• Must strive to provide high quality care, remain efficient and keep administrative costs low, while at the same time ensuring compliance with continuously the same time changing state regulations.
• Should have access to latest generation technology and should deliver enhanced levels of transparency and customer services to their members.
• Mmedical advice integration to capture and deliver medical device data to intergrate portals and databases has to be maintained.
• Disease management guidance, senior care giving and wellness an educational programs.Integrated portals blend with electronic medical records with methods of communication to build seamless and work flows.

These are the various ways by which we can create a seamless regulatory system for all managed care organisations.