MANAGED CARE, ACCOUNTABLE CARE ORGANIZATIONS, HEALTH CARE CONSUMER PLANS/MODELS
There are various types of plans consumers can select. MCOs, HMOs, PPOs, POSs, or ACOs are the most common ones; however they all supply various benefits and drawbacks. Consumers (patients) have the right to choose the type of plan that best fits their needs. As a health care leader, it is vital that you understand the differences in these plans. In addition, in a health care environment where there are plenty of options for consumers (e.g., providers, medical offices, location, consumer plans etc.), ideally making the “choice” is left up to the consumer’s determination.
For the Module 3 Case Assignment, conduct additional research as needed and complete the following:
In your scholarly paper, you should include an introduction and conclusion paragraph.
MANAGED CARE, ACCOUNTABLE CARE ORGANIZATIONS, HEALTH CARE CONSUMER PLANS/MODELS
Required Reading
Blanchfield, B. B. (2019, Dec 23). Value-based care, not volume-based: The traditional fee-for-service “churn and earn” scenario, where the number of patients directly correlates to dollars earned is a disaster. Boston Globe. Retrieved from the Trident Online Library
Brillstein, L. (2020). Value-based care: Rethink, unclench, invite. Managed Healthcare Executive, 30(9), 4. Retrieved from the Trident Online Library.
Haas, S. (n.d.). Health Reform Act: New models of care and delivery systems. Retrieved from https://www.aaacn.org/health-reform-act-new-models-care-and-delivery-systems
Plunkett, L. (2015). Accountable care organizations. New York State Dental Journal, 81(3), 4–7.
Shi, L., & Singh, D. A. (2017). Chapter 9 Managed care and integrated systems. In Essentials of the U.S. health care system (4th ed.). Burlington, MA: Jones & Bartlett Learning. Retrieved from the Trident Online Library.
World Health Organization. (n.d.). Health care delivery models. Retrieved from https://www.who.int/hac/techguidance/tools/disrupted_sectors/module_07/en/index3.html
Wood, D. (2013). Providers getting creative with new healthcare delivery models. Retrieved from https://www.amnhealthcare.com/latest-healthcare-news/provider-getting-creative-new-healthcare-delivery-models/
Videos
Aetna. (2017). What’s the difference between an HMO, a POS, and a PPO? | Health care answers in 60 seconds. [Video file]. Retrieved from https://youtu.be/lvRetvxWjQY
Kaiser Health News. (2015). The ABC’s of ACO’s. Retrieved from https://youtu.be/oV5rxViCf9U
FAIR Health. (2017, November 1). Point of service (POS) (Part 4 of 8)—FAIRHealthConsumer.org [Video file]. Retrieved from https://www.youtube.com/watch?v=gm5eKYjcZbc