How might provider reimbursement and provider satisfaction with the Managed Care organization apply to its consumer...

How might provider reimbursement and provider satisfaction with the Managed Care organization apply to its consumer strength?

Expert Solution

Reimbursement is the actual payments that are received by providers for the benefits that are covered under an insurance plan. Provider reimbursement with the Managed Care Organization (MCO) applies to its consumer strength as by receiving payment in an appropriate and prompt manner the MCO gets the incentive to provide healthcare that is based on superior quality and efficient healthcare. Focus on quality and efficiency adds to the consumer strength of the MCOs.

Provider satisfaction will lead to higher ability of the provider to focus on utilization and quality. There will be a better and improved level of coordination of care and access to knowledgeable utilization management staff. Higher provider satisfaction will mean that MCO is meeting the expectations and needs of the primary care providers (PCPs) and this will enable PCPs to provide high quality and efficient services. This will add onto the consumer strength of the MCOs.

keosha answered 1 year ago

Explain managed care and its impact on consumer-driven health care.

What are the theories of Managed Care Cost Savings? Discuss from both consumer-and provider-side provisions.

.) Is the type of health care provider related to the patient’s satisfaction with care? Data...

.) Is the type of health care provider related to the patient’s satisfaction with care? Data are from a study of 10 patients who were seen for health care at an HMO. Each patient had three different urgent care visits. On one visit, the patient was seen by a physician (MD), at another visit by a nurse practitioner (NP), and at the third visit by a physician’s assistant (PA). After each visit, the patient completed a patient satisfaction survey. Satisfaction...

discuss how managed care managers serve as agents of the consumer. are they good agents?

Discuss diagnostic related groups and it’s effects on reimbursement. Explain Medicare, Medicaid , and managed care...

Discuss diagnostic related groups and it’s effects on reimbursement. Explain Medicare, Medicaid , and managed care as it relates to health care reimbursement .

For Managed Care: Describe the types of care provided. Identify the national organization(s) and the healthcare...

For Managed Care: Describe the types of care provided. Identify the national organization(s) and the healthcare standards for the setting.

How might a consumer view a price cut as an advantage and how might a consumer...

How might a consumer view a price cut as an advantage and how might a consumer view a price cut as a disadvantage? What is deceptive pricing?

A managed care group may want to market their organization as being "the best" or "a...

A managed care group may want to market their organization as being "the best" or "a leader" in providing certain services/ treatment. How can this type or marketing effect quality of care and utilization of services, hence costs? (Minimum of 2 paragraphs including in-text citations and references in proper APA format)

Choose a health care organization or provider with which you are familiar, and describe its patient information capture process.

Choose a health care organization or provider with which you are familiar, and describe its patient information capture process. Does this process support operational effectiveness, satisfy compliance requirements, and promote quality patient care? Explain.

Explain the differences between traditional indemnity insurance and managed health care. Should insurance companies dictate reimbursement...

Explain the differences between traditional indemnity insurance and managed health care. Should insurance companies dictate reimbursement rates for various medical tests and procedures in an attempt to keep prices down?

Question