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Instructions

Compensation & Reimbursement Models in Managed Care

Compensation and reimbursement models are another method of controlling access, cost, and quality in a managed care environment. An MCO doesn’t have direct control over physicians or hospitals but through contractual agreements that set incentives for meeting agreed-upon standards, it can exert influence.

For this project, you are required to write an essay on the following topics:
1) Managed care hospital reimbursement;
2) Managed care provider reimbursement.

Using the South University Online library (e.g. CINAHL) or the Internet, review at least two articles for each topic and write a review for each source of information. Use the following guidelines for developing your essay:

• Write a summary for each topic tying together the information learned about that topic.
• Analyze the market forces that would favor using one reimbursement method over another.
• Evaluate the key differences between different types of payment methodologies from the provider and hospital point of view.
• Evaluate the advantages and disadvantages of the payment methodologies reviewed from the provider and hospital point of view.
• Evaluate new payment methodologies resulting from the Patient Protection and Affordable Care Act (PPACA) and discuss future changes in reimbursement methodologies.
• Compare and contrast each article to the information discussed in the course textbook.

Directions to student: Discuss (in no less than 750 words) both the Managed Care Hospital Reimbursement and Managed Care Provider Reimbursement platforms into four substantive paragraphs 250 words each. Make sure you address the subject topics within the context of the COVID-19. Make sure you include at least four APA-formatted citations/references to include an introduction/conclusion. Submit your work to the Discussion Area.
No Post or Follow-up posts needed.