DEVRY HSM420 MIDTERM EXAM

Question 1. Question
:

(TCO 1) Why were the first proto-HMOs formed in America?
What were the original driving factors in the HMO movement?

:

Question 2. Question
:

(TCO 1) What are the types of plans on the managed care
continuum? Present these in order, from least control to most control of
medical cost and quality.

Question 3. Question
:

(TCO 2) What is the role of the executive director in a
managed care organization? Could you see yourself practicing in this position
at some point in your career? Why or why not?

Question 4. Question
:

(TCO 2) What is the role of the credentialing committee in a
managed care organization? And why is this function so crucial?

Question 5. Question
:

(TCO 3) Discuss pay for performance (P4P) in managed care.
What are the pros and cons of the P4P approach to compensating providers?

Question 6. Question
:

(TCO 3) Describe the use of evidence-based clinical criteria
in managed care. Why is this process so important in managed care today?

Question 7. Question
:

(TCO 4) What is meant by pattern review under managed care?
Why do payers conduct pattern review, and what kinds of things might they
identify during such reviews?

Question 8. Question
:

(TCO 4) Discuss some key general aspects of physician
practice behavior? Include implicit messages from training, and also
environmental factors, in your answer.

Question 9. Question
:

(TCO 7) What is the purpose of hold-harmless and
balance-billing clauses in managed care contracts?

Question 10. Question
:

(TCO 7) What is typically covered under “term, suspension,
and termination” of a managed care contract?

Explanation & Answer

Our website has a team of professional writers who can help you write any of your homework. They will write your papers from scratch. We also have a team of editors just to make sure all papers are of HIGH QUALITY & PLAGIARISM FREE. To make an Order you only need to click Order Now and we will direct you to our Order Page at Litessays. Then fill Our Order Form with all your assignment instructions. Select your deadline and pay for your paper. You will get it few hours before your set deadline.