Evaluate new payment methodologies resulting from the Patient Protection and Affordable Care Act (PPACA) and discuss future changes in reimbursement methodologies.

Current Trends and Issues 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.

This week, you are required to write an essay on the following topics:

  • Managed care hospital reimbursement
  • Managed care provider reimbursement

Using the 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:  Use at least 3 credible resources for the assignment, including at least 1 scholarly peer-reviewed resource.

  • 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.

This paper should be formatted in APA and be 3-5 pages in length without a cover and reference page. Include and introduction and conclusion in your paper. See Project rubric for requirements

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