MANAGED CARE QUESTIONS : APA FORMAT WITH REFERENCES - 22645

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EXAM QUESTIONS

 

 

 

1.    Describe the role of the HMO Act of 1973 in promoting the growth of managed care in the United States. Why was this important?

 

 

 

2.    What are the key, integral components of managed care programs? Can managed care exist without these elements?

 

 

 

3.    Why is managed care likely to continue to be a part of U.S. healthcare moving forward?

 

 

 

4.    Explain the primary differences between managed care programs and the traditional fee-for-service model of healthcare. How is payment methodology different in the two approaches?

 

 

 

5.    What types of physicians are considered primary care providers in most managed care programs? Why are these all considered primary care providers?

 

 

 

6.    Explain the key differences between Preferred Provider Organizations and Health Maintenance Organizations.

 

 

 

7.    How would you describe an integrated care system? What does it look like in practice?

 

 

 

8.    Why are solid information systems so important in managed care? A managed care information system should be relied on for what core operational competencies?

 

 

 

9.    What are some of the factors which make it difficult to achieve truly integrated systems of care in the United States?

 

 

 

10.What is a case manager? State the four major areas of professional activity for a case manager.

 

 

 

11.What management tools would a hospital need to be able to effectively operate in a heavily capitated environment?

 

 

 

12.  What are the three primary measuring indicators of quality in healthcare?

 

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