Reference no: EM133397953

Application Exercise

Question 1.  Share a news story about managed care in your state or in the nation. Categorize the story as a positive, negative, or neutral portrayal of managed care. In class or during an online discussion, tally the numbers of positive, negative, and neutral portrayals.

Question 2.  If the previous exercise did not result in many positive news stories about MCOs, expand the search.

Question 3. Consider tendencies of news media. Do positive stories get as much coverage? To gain the perspective of the news media, read the following article: Sherman, W. 1997. A news reporter explains his 'HMO horror stories'. Managed Care 6(9):61-64.

Question 4.  Review the appeal clauses in the policies of managed care plans. Are there common characteristics?

Real-World Case Study

Medicaid managed care organizations vary from state to state. Moreover, like all third-party payers, the MCOs operate in healthcare's constantly changing environment. Kaiser Family Foundation tracks and reports sociodemographic and third-party payer data.

Answer the following questions:

1. What is the percentage of HMO penetration of your state?
2. What is the percentage of HMO penetration of a neighboring state?
3. What is the percentage of HMO penetration for the United States?
4. How do these percentages compare?
5. Your instructor may assign other questions for you to answer.