Nursing-Managed Care
Read chapter 9 materials and complete the following in order for Managed Care: o Managed Care Introduction o Managed Care PowerPoint o Health Insurance (video) o Medicaid (video) o Pay for Performance o Genetic Testing Complete Study: 1. In the managed care arena, what is capitation? Who are the “Gatekeeper” and their duties? 2. What […]
Nursing-Case Study
You are the newly appointed director of quality management at a medium-sized MCO that was originally a group model but now have about half of its members cared for by physicians in a network model arrangement. NCQA has recently adopted and promulgated a new set of measures for quality of care of diabetics and you […]
Nursing
Your 73-year-old Uncle Henry lives in Pennsylvania and is looking for a Medicare PPO to join. It is open enrollment and he has asked for your help. Uncle Henry knows that you work as a Health Information Technician and you have knowledge about health plans. He has several chronic diseases including diabetes, hypertension, and Parkinson’s […]
