SOLVED: HLT-308V Reflective Analysis: Risk Management and the Role of Managed Care
Grand Canyon University SOLVED: HLT-308V Reflective Analysis: Risk Management and the Role of Managed Care-Step-By-Step Guide
This guide will demonstrate how to complete the Grand Canyon University SOLVED: HLT-308V Reflective Analysis: Risk Management and the Role of Managed Cares assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for SOLVED: HLT-308V Reflective Analysis: Risk Management and the Role of Managed Cares
Whether one passes or fails an academic assignment such as the Grand Canyon University SOLVED: HLT-308V Reflective Analysis: Risk Management and the Role of Managed Cares depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for SOLVED: HLT-308V Reflective Analysis: Risk Management and the Role of Managed Cares
The introduction for the Grand Canyon University SOLVED: HLT-308V Reflective Analysis: Risk Management and the Role of Managed Cares is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
How to Write the Body for SOLVED: HLT-308V Reflective Analysis: Risk Management and the Role of Managed Cares
After the introduction, move into the main part of the SOLVED: HLT-308V Reflective Analysis: Risk Management and the Role of Managed Cares assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for SOLVED: HLT-308V Reflective Analysis: Risk Management and the Role of Managed Cares
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for SOLVED: HLT-308V Reflective Analysis: Risk Management and the Role of Managed Cares
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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Assessment Description
The purpose of this assignment is to analyze the role of managed care organizations within health care and risk management programs.
Reflect on and evaluate the role that the managed care organization (MCO) plays in today’s health care environment by developing a 250‐500-word response that addresses the following:
What is a health care organization’s administrative role in executing risk management policies and ensuring compliance with managed care organization (MCO) standards?
What value do the regulatory statutes of a typical MCO provide to a health care organization? Consider how strategies pertaining to policies such as conflict resolution and risk management affect patients as well as employees and employers.
What MCO responsibilities relevant to the Patient Protection and Affordable Care Act (ACA) and Center for Medicare and Medicaid Services (CMS) focus on fraud, waste, and abuse laws?
In addition to your textbook, you are required to support your analysis with a minimum of two peer‐reviewed references.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Reflective Analysis: Risk Management and the Role of Managed Care
Risk management is an instrumental tool in the prevention of risk in the healthcare system and in ensuring the safety of patients and healthcare providers within the healthcare setting. On the other hand, Managed care organizations (MCO) characterize integrated entities that strive to minimize healthcare costs (Wolfe et al., 2020). The implementation of the MCOs has transformed healthcare delivery through financial provisioning, preventive medicine techniques, and treatment directives. Healthcare professionals should understand MCOs’ policies because they influence different aspects of care delivery, utilization management, medication formularies, financial incentives, and provider networks. The purpose of this paper is to reflect on and assess the role of MCO in the current healthcare environment based on the specific questions provided.
What is a health care organization’s administrative role in executing risk management policies and ensuring compliance with managed care organization (MCO) standards?
A health care organization plays a critical administrative role in executing risk management policies and ensuring compliance with MCO standards. The administration of a healthcare organization controls risk through the identification and assessment of the risk to prevent or reduce harm or damage to the healthcare workforce, patients, and other stakeholders. The identification of risk involves becoming conscious of the environmental threats and working proactively to prevent or reduce the damages of the risk (Arab et al., 2019). The administration of the organization is responsible for risk analysis, which entails the creation of an understanding of the recognized risks and ascertaining the risk level, causes, and available measures to address the risks. Another administrative role is to design laws and programs to involve the stakeholders and public in decision-focused processes. The other healthcare organization’s administrative role is to ensure a comprehensive provider contract that entails clear criteria for hiring healthcare providers and the process of terminating the staff that fails to attain the MCOs’ quality standards.
What value do the regulatory statutes of a typical MCO provide to a health care organization? Consider how strategies pertaining to policies such as conflict resolution and risk management affect patients as well as employees and employers.
The regulatory statutes of a typical MCO play a critical role in enabling a healthcare organization to provide quality and affordable care. Regulatory statutes compel healthcare settings to ensure that the cost of health care is cost-effective by closely monitoring how the enrollees utilize healthcare. It is easier to control the cost of health care when the wasteful utilization of services is prevented. The MCO’s regulations compel the patients to get the approval of their plans before getting specialized treatment or hospitalization (Wolfe et al., 2020). On the other hand, the strategies pertaining to policies such as conflict resolution and risk management affect patients, employees, and employers in different ways. Risk management policies are intended to avert possible financial implications and patients’ needs are fundamental. As such, employers are expected to ensure that the risk management policy promotes the safety of employees and patients. The policies should entail patient-oriented risks and should equally be available to the employees.
What MCO responsibilities relevant to the Patient Protection and Affordable Care Act (ACA) and Center for Medicare and Medicaid Services (CMS) focus on fraud, waste, and abuse laws?
MCOs are obligated by the ACA and CMS regulations to implement detailed programs to enhance billing processes to discover and avert fraud, waste, and abuse in healthcare. In MCO, the risk is transferred to a liaison insurer from the principal payer, who can be penalized for fraud, abuse, and waste such as providing inferior care, denying services to the client, and creating logistical and administrative barriers to clients (Ekin, 2019). The other responsibility of MCOs is the identification, investigation, and dealing with probable abuse and fraud. They are also required to provide the encounter to the CMS for scrutiny to discover fraud and abuse.
Conclusion
A health care organization plays a critical administrative role in executing risk management policies and ensuring compliance with MCO standards by ensuring risk analysis and prevention of harm and damages. The regulatory statutes of a typical MCO play a critical role in enabling a healthcare organization to provide quality and affordable care. The MCOs are obligated by the ACA and CMS regulations to implement detailed programs to enhance billing processes to discover and avert fraud, waste, and abuse in healthcare.
References
Arab, M. A., Khankeh, H. R., Mosadeghrad, A. M., & Farrokhi, M. (2019). Developing a hospital disaster risk management evaluation model. Risk management and healthcare policy, 12, 287. Doi: 10.2147/RMHP.S215444
Ekin, T. (2019). Statistics and health care fraud: How to save billions. Chapman and Hall/CRC.
Wolfe, M. K., & McDonald, N. C. (2020). Innovative health care mobility services in the US. BMC public health, 20(1), 1-9. https://doi.org/10.1186/s12889-020-08803-5