Role of managed care organizations within health care

Reference no: EM133731538 , Length: Words Count:1000

The purpose of this assignment is to analyze the role of managed care organizations within health care and risk management programs.

Reflect on and evaluate the role that the managed care organization (MCO) plays in today's health care environment by developing a 750 to 1,000-word response that addresses the following:
Explain what a health care organization's administrative role is in executing risk management policies and ensuring compliance with managed care organization (MCO) standards.

Explain what value the regulatory statutes of a typical MCO provide to a health care organization and include strategies pertaining to policies such as conflict resolution and risk management that affect patients and families as well as employees and employers.

Explain what MCO responsibilities relevant to the Patient Protection and Affordable Care Act (ACA) and Centers for Medicare and Medicaid Services (CMS) focus on fraud, waste, and abuse laws.

Identify strategies that can be implemented for developing a culture of reporting and transparency.
In addition to your textbook, you are required to support your analysis with at least three credible health-related resources.

Reference no: EM133731538

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