Let us delve into the challenges faced by NBMC and the strategies employed to adapt to managed care requirements. The case study of NBMC highlights the complex interplay between managed care and healthcare delivery. Understanding the challenges posed by managed care and implementing proactive strategies to adapt to its requirements, healthcare organizations can optimize care delivery, enhance patient outcomes, and thrive in an evolving healthcare landscape. Research the challenges and strategies necessary to overcome those challenges in healthcare delivery under managed care. Some challenges that exist, but not limited to are: Care Coordination, Provider-patient relationships, Patient Access, and Financial constraints.
Utilize your research for the summary paper assignment on the challenges in healthcare delivery under managed care, and discuss your view on the below items:
How can healthcare providers effectively engage patients in shared decision-making and self-management support within the framework of managed care?
What initiatives can be adopted to optimize managed care delivery and enhance patient outcomes?
How might the evolution of managed care models, such as accountable care organizations (ACOs) and bundled payments, impact healthcare delivery in the future?
Provide a minimum of two references in APA format. Provides accurate and properly formatted in-text citations for all sources referenced in the discussion.
All initial posts need a reference. Your initial post should never be all opinion. You need to refer to the reading and prior research.
Plagiarism of 20% or more result in a “0”.
Part 2
Managed care programs come in several varieties. HMOs (health maintenance organizations) and PPOs (preferred provider organizations) are two of the most common. The majority of others combine the two. With the exception that each managed care plan’s duties differ significantly from the next, the fundamental role of governance and control in HMOs, PPOs, and other plans are the same as those in any other organization.
The use of a provider network with discounts, prior approval of procedures, utilization management of treatment guidelines, utilization review, case management, peer review and second opinions, prospective, concurrent, and retrospective audits, and grievance procedures are just some of the cost-controlling strategies employed by managed care programs.
Review the resources listed in the weekly resources to prepare for this week’s assignment(s).
“Identify a local non-profit health care organization that uses a managed care model. You can either conduct an interview with a senior leader of the organization (this may be the CEO, COO, a Senior Vice-President, Vice-President or other such position) OR research about the organization itself. A useful example can be found in many issues of the Journal of Healthcare Management, which often publishes interviews with health care leaders, including on this topic. Interview the individual or research on their managed care model, challenges, its advantages and disadvantages, and why their system does not use other models of managed care. You may also include other interview questions of your choosing, as long as they are relevant to the overall topic of the paper.”
Once you conduct your interview or research, summarize your findings on the main managed care model utilized.
Requirements:
Submit ONE (minimum) to TWO-PAGE (maximum) PAPER by Sunday 11:59pm. Ensure that the paper is formatted as a single page without exceeding the page limit.
Use Times New Roman or Arial, size 12.
Set 1-inch margins on all sides of the paper.
1.15 space the entire document.
Use concise language and avoid unnecessary words or phrases.
Provide a minimum of three references in APA format. Lists all sources cited in the paper on a separate references page.
Provides accurate and properly formatted in-text citations for all sources referenced in the paper.
Save the document in a commonly used file format (e.g., Microsoft Word, PDF) and save it as “your last name” dash week1. Example: Wongkargut-week2
