Managed care organization

Managed care organization

Reflect on and evaluate the role that the managed care organization (MCO) plays in today’s health care environment by developing a 750-1,000-word response that addresses the following:

· Explain what a health care organization’s administrative role is in executing risk management policies and ensuring compliance with managed care organization (MCO) standards.

· Explain what value the regulatory statutes of a typical MCO provide to a health care organization and include strategies pertaining to policies such as conflict resolution and risk management that affect patients and families as well as employees and employers.

· Explain what MCO responsibilities relevant to the Patient Protection and Affordable Care Act (ACA) and Centers for Medicare and Medicaid Services (CMS) focus on fraud, waste, and abuse laws.

· Identify strategies that can be implemented for developing a culture of reporting and transparency.

https://www.ncbi.nlm.nih.gov/books/NBK559326/

https://www.definitivehc.com/resources/glossary/managed-care-organization

Related Questions HLT-308V Reflective Analysis: Risk Management and the Role of Managed Care