What effects would joining a MCO have on your clinic regarding staffing, patient volume, and financial stability?
To support your work, use your course and text readings and also
use outside sources. As in all assignments, cite your sources in
your work and provide references for the citations in APA format.
Start reviewing and responding to the postings of your
classmates as early in the week as possible. Respond to at least
two of your classmates. Participate in the discussion by asking a
question, providing a statement of clarification, providing a point
of view with a rationale, challenging an aspect of the discussion,
or indicating a relationship between two or more lines of reasoning
in the discussion. Complete your participation for this assignment
by Wednesday, June 22, 2016.
MCOs
You are a new physician setting up your own practice in a new
town. You are researching the different MCOs offered in your area
and are considering becoming a physician for one of these networks.
You have also invited the sales representatives of several health
plans to speak with you about the benefits of choosing their plans.
Based on the above scenario, answer the following questions:
• What effects would joining a MCO have on your clinic
regarding staffing, patient volume, and financial stability?
• What policies and procedures should be used by the MCOs to
reduce costs for their clientele?
• Discuss the ethical issues or concerns about MCOs providing
a lower quality of care compared to traditional fee-for-service
(FFS) organizations?
• What are some of the questions you would ask each
representative about his or her company’s specific plan that will
help you make a decision?
• Do you believe that the evolution of MCOs and consumer
driven health plans (CDHPs) has affected the healthcare environment
today by integrating the financing and delivery of healthcare
services? If yes, how?
• How have the roles and relationships between physicians and
patients changed by each of these types of plans?
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