Managed Care Case Study

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You are a new physician setting up your practice in a new town. You are researching the different MCOs offered in your area and are considering becoming a physician for one of these networks. You have also invited the sales representatives of several healthy plans to speak with you about the benefits of choosing their plans. Based on the above scenario, answer the following questions: • What effects would join an MCO have your clinic regarding staffing, patient volume, and financial stability? The Managed Care Organizations it continues the expansion of the products. The MCO business models it changes the services in mixing and volume of the patients and the representation on the multi-year contracts. It provides profiling to the current …show more content…

The effects can be made through claiming through managed care by the organization. The managed care for the delivery and principles of finances, the patients and physicians must follow the policies and procedure of the health plans. The drug benefits in a pharmacy can be reduced in costs from 40 % to 10% comparing to people who are members and the non-members. The reimbursement if any the mechanism should be used by the MCOs that are effective. The MCOs should make sure that as much as the cost is low the services should be of a quality to make the patient keep coming. It increases the demand for the services and word spreads of the physicians (Peloso, …show more content…

How do they make sure that the services they provide are effective? How sure they that the staff members are are satisfied working in the company? If not what is being to make sure that the performance of the staff members improves? Concerning the organization is the financial company stable and at some point will it go through bankruptcy. What are they doing to make sure that the customers will keep coming back? How would they describe the medical health plan and the health care quality being provided? • Do you believe that the evolution of MCOs and consumer-driven health plans (CDHPs) has affected the healthcare environment today by integrating the financing and delivery of healthcare services? If yes, how? I do not believe that the evolution of the MCOs and consumer-driven health plans has affected the healthcare environment today by integrating the delivery and financing of the healthcare services (Peloso, 2002). • How have the roles and relationships between physicians and patients changed by each of these types of

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