What is the percentage of hmo penetration in virginia state

Reference no: EM133371690

Case Study: DISCUSSION

Please describe what Stark II is. When you consider the laws/regulations such as Stark II-Physician self-referral-does it seem to you that congress (particularly Fortney (Pete) Stark) has an axe to grind against physicians? If yes, why would that be? Why would congress care about physician ownership of provider organizations?
What does it mean when they accuse physicians of "cherry-picking" healthcare procedures on the basis of profitability?
Application Exercise

1. Share a news story about managed care in Virginia state or in the nation. Categorize the story as a positive, negative, or neutral portrayal of managed care. Tally the numbers of positive, negative, and neutral portrayals.

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

3. Consider the 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.

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.

Go to the organization's website: https://www.statehealthfacts.orgLinks to an external site. and click Health Insurance & Managed Care.

Questions: Answer the following questions:

What is the percentage of HMO penetration in Virginia state?
What is the percentage of HMO penetration in a neighboring state?
What is the percentage of HMO penetration in the United States?
How do these percentages compare?

Reference no: EM133371690

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