PROVIDE A RESPONSE OR STATEMENT TO THIS STUDENTS DISCUSSION: Q1. Please share yo
ID: 123591 • Letter: P
Question
PROVIDE A RESPONSE OR STATEMENT TO THIS STUDENTS DISCUSSION:
Q1. Please share your experience on selecting a managed care plan. Please discuss the advantages and disadvantages of your MCO plan.
A1. I’ve not experienced selecting a healthcare plan. Early in my adult life I enlisted in the military at the age of 18 and was provided healthcare through a Military Treatment Facility or referral in the local community through TRICARE (a type of HMO plan). I am assigned a provider and that provider manages my care; my choices are limited. Referrals must be coordinated and approved by my provider in advance. Additionally, I do not typically choice the specialty referral facility/provider; it is selected based on in-network providers through TRICARE. I’ve not had any issues with this type of managed care and have a positive view of my healthcare needs being met.
Q2. Many argue that there is no consistent, direct correlation between the cost of care and its quality in a managed care program. Do you agree or disagree?
A2. I often think about this, specifically in regard to capitation. For instance, my insurance coverage agrees to pay $30 for an office visit while the totality of the bill is much more at $130 per visit. In the back of my mind I am thinking about the quality of care versus quantity as this model seems to thrive from. I have no personal examples where the cost of care had a direct effect on the quality of care I received. I believe there is goal to improve quality of care. One such initiative is the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey sent to patients for their perspective on measuring the quality of care they received (BCBS, 2014). The survey help consumers make an informed decision. Similar to the popular app Yelp.
Q3. Do you think patient’s choice of provider and access to care will be limited under ACOs?
A3. I do not think that choice is limited under an ACO. In fact, over 23 million Americans are on a type of ACO (Gold, 2015). An ACO brings together a network of providers (specialty and otherwise) to provide service to a patient.
Q4. In what ways can an ACO succeed in both delivering high-quality care and spending health care dollars more wisely? A traditional fee-for-service drives up costs by billing per visit/procedure/exam. An ACO provides participating organizations a bonus to keep costs lower and mitigate unnecessary visits/procerfures/
Explanation / Answer
1. Response for first answer.
Well..you explained your answer. MCO means managed health care for families. healthcare members will come to your home and take care of yours. here you need to mention about it and you did not mention about advantages and disadvantages. mentioned advantages like cost effective, qualified members would provide the care, the offices are at reachable distance. Disadvantages like we dont have privacy.
2. Response to second answer
The answer is not that so appropriate and may be irrelavent, they asked about how MCO is cost effective in providing care and whether it can be able to provide the quality of care or not.
3. Response to third answer
Answer is correct but you would have mention more about ACO...What is ACO, how it is associated with MCO.
4. Response to fourth answer
Simply answered correctly.
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