Our Services

Get 15% Discount on your First Order

This is the book and the questions are attached as well Nursing Assignment Help

January 17, 2024

This is the book and the questions are attached as well

Kongstvedt, Essentials of Managed Care, Sixth Edition ISBN: 978-1-4496-5331-6

Based on Chapter 2: Types of Health Insurers, Managed Health Care Organizations and Integrated Healthcare Delivery Systems

Discuss the principle elements of control found in each type of managed care plan. In which plans do those elements appear?

Discuss the primary strengths and advantages; and weaknesses and disadvantages of each type of managed care plan.

Based on Chapter 4: The Provider Network

Describe a typical physician credentialing process, indicating which steps are required and why they are required. Discuss possible problems that may arise for any steps that are not completed.

Based on Chapter 5: Provider Payment

Discuss the main forms of facility payment, differentiating inpatient and ambulatory, and the impact of outliers and carve-outs.

Based on Chapter 7: Basic Utilization and Case Management

Discuss the key attributes of managing basic medical-surgical utilization in different types of managed care plans.

Describe the differences between case management and UM.

Based on Chapter 9: Physician Practice Behavior and Managed Health Care

Discuss the reasons for an increased interest in managing physician practice behavior.

Based on Chapter 10: Data Analysis and Provider Profiling in Health Plans

Discuss the most common technical, clinical, and organizational problems medical directors face in using data to manage utilization, and what steps might be taken to deal with those problems.

Based on Chapter 14: Quality Management in Managed Health Care

Describe the strategies an MCO can use to involve physicians in managed care processes.

Assignment, attached, Book, nursing, questions

Share This Post

Order a Similar Paper and get 15% Discount on your First Order

Related Questions

Individual work (Do not share or copy review with others.)

Individual work (Do not share or copy review with others.) Review can be maximum of 2 pages (font: Arial, Calibri, or Times New Roman, size: 11). It should provide the following: 1. Title and author of the paper 2. Summary of a paper Provide a summary of new structure/framework presented

Please use University of Pittsburgh Department of Pathology case study

Please use University of Pittsburgh Department of Pathology case study collection. Search for a case that is interesting for you and applicable to a microbiology course. You can either search by “microbiology” in the search box and then browse the cases, or search for a specific diagnosis. To be appropriate

Discuss why viruses are more difficult to treat than bacteria

Discuss why viruses are more difficult to treat than bacteria and how they affect our body. Identify properties of viruses, characteristics, viral nucleic acids and life cycle of animal viruses. (You can help yourself to answer this question reading the PowerPoint in the Modules here in Canvas Chapter 5 Viral

As a new health care manager, you will need to

As a new health care manager, you will need to have an organizational chart of the facility and of your department. Complete the following for this assignment: In PowerPoint or Word, develop a simple organizational chart for a facility or for 1 department. Make this chart original. Do not

For this discussion, compare and contrast “the many faces of

For this discussion, compare and contrast “the many faces of resistance” (Dallas) and “I don’t get it; I don’t like it; I don’t like you” approach (Maurer), and respond to the following: Which do you feel is most useful and practical? Why? What, if anything, would you add to

Instructions Choose one of the psychological disorders discussed in the

InstructionsChoose one of the psychological disorders discussed in the textbook (i.e. generalized anxiety disorder, panic disorder, bipolar disorder, schizophrenia, etc.) and create a fictitious case study of someone who exhibits the behaviors of this disorder. Academic case studies typically focus on a single individual or small group of people,

Humans have been making decisions throughout history. The methods that

Humans have been making decisions throughout history. The methods that we have used historically to make decisions are now being replaced, in some cases, with more advanced decision-making methods. Is this a positive change? Think of an example where a more advanced method produces a positive or negative result. Considering

These can be guidelines, scholarly articles, or other evidence-based sources

These can be guidelines, scholarly articles, or other evidence-based sources written within the last five years. Along with this list include one to two sentences explaining how you plan to use them in your project. Submit the three resources in APA format. This reference list is not all inclusive;

this assignment is due in 7 hours and no extended

this assignment is due in 7 hours and no extended time Use the attachment chapter 6 to answer the 2 questions below: Chapter 6: Teachers’ Voices: Rethinking Teacher Education for DiversityIn Chapter 6, Delpit discusses the issues involved in restructuring the teacher education programs in the United States so that

PU Hypertension with Toxic Exposure Risk Activity in Nursing Assignment Help

I’m working on a health & medical discussion question and need guidance to help me learn. Please add your own opinion and review the following examples of supporting evidence. -Cites Medical Literature with an explanation on how the literature applies to the veteran. -Rules out any other possible etiologies. -Discusses

Section 1: Advocacy Rationale- This information can be found in

Section 1: Advocacy Rationale– This information can be found in Module 1 of the course material Section: 2: Policy Making Process-This information can be found in Module 1 of the course material Section 3: Building New Policy Agenda- This information can be found in Module 2 of the course

1 3 Title of Your Essay Your First and Last Name Post University Course Code: Name of Course (e.g. ENG 122: English

1 3 Title of Your Essay Your First and Last Name Post University Course Code: Name of Course (e.g. ENG 122: English Composition II) Instructor Name Due Date Title of Your Essay Start the first paragraph here, which should introduce your reader to the subject you are writing about. Do

The Fall of the Aztec Empire

Please talk about and describe the fall of the Aztec Empire. The paper must have 3 primary sources and 3 secondary sources. A primary source is anything that comes from the particular time period that you are studying. For this topic many primary sources come from the Spanish or Catholic

Jacey works as a receptionist at a medical office. While Nursing Assignment Help

Jacey works as a receptionist at a medical office. While performing all the office duties, as well as greeting patients as they check-in for appointments, she developed an idea that could make the check-in process faster and the paperwork more efficient and streamlined. She wants to share this information with

Research question: What are the pros and cons of informatics,

Research question: What are the pros and cons of informatics, crowdsourcing, and artificial intelligence in clinical nursing? What about the use of these in nursing education? Write a professional summary using research methods learned in other Courses. Two full pages of content.Double spaced.There is a 2-3 sentence summary at the

ASU Health & Medical Hematopoietic & Cardiovascular Discussion Nursing Assignment Help

Hematopoietic: J.D. is a 37 years old white woman who presents to her gynecologist complaining of a 2-month history of intermenstrual bleeding, menorrhagia, increased urinary frequency, mild incontinence, extreme fatigue, and weakness. Her menstrual period occurs every 28 days and lately there have been 6 days of heavy flow and

The written introduction consists of five parts for which a

The written introduction consists of five parts for which a separate paragraph can be devoted for your introduction. 1. State the research problem. 2. Review studies that have addressed the problem. 3. Indicate deficiencies in the studies. 4. Advance the significance of the study fro particular audiences. 5. State the