types of models for managed care

Part 1

Within the Discussion Board area, write 250-350 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas.

Using the Beyond the Book resource and online and digital resources, discuss different types of models for managed care. Address the following:

Discuss at least 1 reason why the managed care delivery model was created.
Describe at least 2 different types of managed care, including their differences.
Identify at least 1 advantage and 1 disadvantage of the managed care model.

NOTE: Use at least two scholarly references and cite using APA format.

Part 2

How healthcare services are provided is constantly changing. While historically, emergency departments (ED) was physically located within the hospital building, the standalone Emergency Department also referred to as the Free Standing Emergency Department (FSED) has become a new model for delivery of emergency services within communities. Consider yourself in the role of a consultant to a healthcare organization, financial manager, or ED administrative director. You have been asked to provide the CEO and leadership with pros and cons of establishing a Free Standing Emergency Department. You are aware of the news stories about these types of facilities, and you will want to review The Washington Post article at this as you prepare your review.

Include in your discussion:

Differences between off campus emergency departments (OCEDs) and independent free standing emergency centers (IFECs). What would be the advantage to the healthcare organization of an OCED?
How would services provided be reimbursed either by private insurance or Medicare/Medicaid?
What are the advantages or disadvantages to the community of an FSED? Would members of the community favor an OCED or an IFEC?
Why are most of the FSEDs located in Texas, Colorado and Ohio?
Based on your research and the news stories about FSEDs, what would you recommend to the CEO and Board of Directors?

NOTE: Use at least two scholarly references and cite using APA format.

Part 3

Physicians and other providers of clinical care play a key role in delivery of healthcare. With the various models of reimbursement and goals of cost containment, the role of the physician in managing patient care has changed.

Describe two reimbursement models and the role of the physician in each model.
How do government and private insurers influence how physicians practice today?
Why is accurate and complete documentation in the electronic health record important to reimbursement and quality of care?
What other members of the healthcare team who do not provide direct care to patients contribute to cost containment and delivery of healthcare services

NOTE: Use at least two scholarly references and cite using APA format.

Part 4

Review and reflect on the knowledge you have gained from this course. Based on your review and reflection, write at least 3 paragraphs on the following:

Identify one challenge you see in the U.S. health care system today. What healthcare organizations/departments are impacted?
Identify one government agency and its role in meeting the challenge?
Considering your career goals in the healthcare industry, how would your role as a member of the healthcare team and your team be involved in meeting the challenge?
What did you learn in this course that was most surprising or unexpected from when you started the course?