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Managed care is a complex system involved in the financing and delivery of health care. The main goals of this system are to control access, quality, and cost of health care. MCOs have complex relationships or contracts with buyers (employers or individuals), providers (health care facilities and physicians), and consumers (patients). To this end, there is a need for complex management structures to organize and oversee these relationships.
There are six different medical management committees typically formed within an MCO. Some serve operational purposes while others serve to meet regulatory and quality standard functions. Refer to the readings of this week and answer the following questions:
After answering the above questions, read the following information:
The development of MCOs has been influenced by the type of market they serve. For example, BCBS companies moved from primarily a service plan provider to a multiproduct line that includes HMO, PPO, and consumer choice plans. In addition, various types of managed care organizations have emerged due to forces imposed by the state and the federal governments, such as the HMO Act of 1973. Answer the following questions keeping in mind the above information:
Sharp Discounts Wholesale club has two service desks, one at each entrance of the store. Customers arrive at each service desk at an average of one every six minutes
What must the members of an Action Learning Team (ALT) consider in an attempt to address the problem and build toward a positive mental model conducive to company survival?
Marketing planning must be aligned with the organizational strategic plan and is based on a situational analysis. The marketing planning must also be implemented and controlled.
Line will operate for 450 minutes per day. Illustrate what is minimum number of workstation needed if maximum output rate is to be sought. Illustrate what range of output is theoretically possible for line.
Create a SWOT analysis. Included in this report should be the company's official mission statement and how you feel the company is meeting its mission.
1. does outback steakhouse have any substantial impacts for their growth expansion plans?2. identify outback steakhouse
Consider an irreducible Markov chain with n states {0,1,n} where the transition probabilities are: p_(i,i+2) = 1/2 and p_(i,i-1) = 1/2. Is this chain ergodic? If not, what is the period?
Calculate the sustainable growth rate using the financial data for the most recent year for the company. Show the inputs and the steps to generating the result.
The corruption perceptions index (CPI) is a comparative assessment of integrity performance for a variety of countries. What is CPI? What is its purpose? What is the value of this index? What are the trends or similarities between countries with the ..
describe how much investment also debt to undertake during the next yr. Each dollar invested reduces the NPV of my organization by 10 cents also each dollar of debt increases the NPV by 50 cents.
What factors should Adel consider in deciding whether to use a team for the negotiation? How should Adel decide whom to take to the negotiation? Provide reasons.
Is training the answer? If so, what kind of training should be done? What other actions may be appropriate?
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