The Affordable Care Act (ACA) currently includes provisions for
Accountable Care Organizations (ACO) and Patient Centered Medical
Homes. What are these entities and how may they be related to
managed care?
Accountable Care Organizations (ACOs) are an experiment of the
Affordable Care Act (ACA) that will affect reimbursement across
most outpatient areas in particular. and discuss what strategies
providers may need to implement in ACOs to maintain cost
effectiveness with this potential system.
What are your thoughts about the emerging accountable care
organizations? In what ways do you think they will affect the
current health care delivery system?
What are the implications of expanded use of capitation,
Accountable Care Organizations, and related payment approaches that
put providers and/or payors at financial risk for high levels of
utilization? What is the difference between management’s efforts to
control utilization and maintain adequate services, and
management’s efforts to maximize utilization? How can provider
groups that accept capitation risk internally allocate payments to
clinical professionals and institutional providers in a manner that
creates appropriate incentives?
Discuss the differences and similarities between Managed Care
Organizations (MCOs) vs. Accountable Care Organizations (ACOs).
Given the current health care environment, provide a solid
speculation to how MCOs and ACOs may transform to meet the needs of
its consumers. Be sure to support your thoughts and analysis with
scholarly sources.
1. The Accountable Care Act (ACA) led to hospitals:
A.
Refusing to treat Medicaid patients.
B.
Focusing more on volume than on the quality of care.
C.
Increasing preventable readmissions.
D.
Participating in the Value-Based Purchasing Program.
2. State regulation and accreditation requirements for quality
reporting by Managed Care Organizations help address potential
problems with:
A.
Over-care
B.
Rising costs
C.
Under-care
D.
Outliers
3. True or False: Because there are few close substitutes for
medical services, the demand for...