Role of Managed Care
Reflect on and evaluate the role that the managed care organization (MCO) plays in today’s health care environment by developing a 275-300 word response that addresses the following:
1. What is a health care organization’s administrative role in executing risk management policies and ensuring compliance with managed care organization (MCO) standards?
2. 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.
3. What MCO responsibilities relevant to the Patient Protection and Affordable Care Act (ACA) and the Center for Medicare and Medicaid Services (CMS) focus on fraud, waste, and abuse laws?
