Answered: Describe the risks of managed care and…

Describe the risks of managed care and utilization review. What are examples of legal actions that have resulted. A review of the mechanisms that are in place to prevent such failures

Practical Management Science

6th Edition

ISBN:9781337406659

Author:WINSTON, Wayne L.

Publisher:WINSTON, Wayne L.

Chapter2: Introduction To Spreadsheet Modeling

Section: Chapter Questions

Problem 20P: Julie James is opening a lemonade stand. She believes the fixed cost per week of running the stand...

See similar textbooks

Related questions

Q: 1. What are the major differences in Government Sourcesand Managed Care Source? 2. Explain the two…

A: Managed care is a health care delivery system that is organized to manage cost, utilization, and…

Q: Discuss the concept of Health and Safety Management in an organisation.

A: Health and Safety Management within an organization encompasses a multifaceted approach aimed at…

Q: Locate your professional code of ethics for EMTs. Does the code of ethics address autonomy,…

A: EMT means Emergency Medical Technician Those paramedical staff which provide emergency medical…

Q: What are the core functions of an EHR System? What are the benefits of using an EHR?

A: EHR, or Digital Health Information, is employed to convert a individuals' clinical data onto digital…

Q: Employees with diabetes ant other conditions often need to inject themselves at work to manage their…

A: Human Resource Management: Human resources management is the process of managing the human element…

Q: Describe the strategic planning in a hospital organization and how legal and ethical considerations…

A: Planning, coordinating, and regulating resources to accomplish organizational objectives are all…

Q: Discuss how temporary workers and part-time workers used effectively in a health care organization

A: Temporary or part time workers are those workers who are hired for a specific project or for certain…

Q: what is the importance of the Community and Service Networking in human services?

A: Human services are essential programs that aim to help individuals and communities address a wide…

Q: 89) What are some benefits from an ACO? a) Better patient provider engagement b) Higher overall…

A: ACOs refers to Accountable care organizations

Q: Why should I review my job hazard analysis?

A: Safety rules must be followed by everyone in the organization because it plays an important role in…

Q: Why are standards of care required for healthcare professionals and organizations? How can I…

A: It is of the utmost importance in the field of healthcare to guarantee the highest possible level of…

Q: Please explain in detail Offer three ways an affiliated acute care organization differs from a…

A: Although treatment environments might vary, they are sometimes referred to as acute care or…

Q: Analyze the purpose and needs of a long term care faciltiy

A: The purpose of a long term care facility is to provide a variety of services to individuals who are…

Q: The guidelines for responding to incidents outline what roles incident teams should play and how…

A: Incident response is a set of rules followed by a company to govern the cases related to a security…

Q: How os the clinical environment affects the practice management in the Healthcare organization

A: Below is the solution:-

Q: Find out and draw the organizational structure (Hospital Hierarchy Chart) for Savannalamar Hospital…

A: With the help of an organizational chart/hospital hierarchy chart, we can visualize a company's…

Q: what is a Routine job hazard analysis

A: Hazard could be anything that brings harm on us or on the health of organization or both. Any unsafe…

Q: Explain the concepts if Measurement, Manipulation and Experimentail Procedures.

A: About Marketing -Marketing is a concept which can be described as a relevant kind of process. In a…

Q: explain discrete event simulation in health care system

A: Discrete-event-simulation often called DES can be stated as the approach that is utilized to model a…

Q: Describe a scenario where a medical professional may judge a patient unfairly.

A: Introduction- The doctors are considered to be a figure next to god. The medical professionals are…

Q: What are the major steps in the coding and billing workflow process in an EHR?

A: Any Electronic Health Record (EHR) seems to be an electronic representation of something like a…

Q: Post an explanation of how a current event that occurred within the past five years might have…

A: INTRODUCTION - One of the toughest challenges for every business owner is navigating ethical issues…

Q: four sources of law in the United States

A: Laws are the rules and regulations that is established to maintain stability and justice in a…

Q: Discuss what the term standard of care means for someone in your profession.

A: The standard of care in business is the level of care that a reasonable and prudent businessperson…

Q: What is the role of an ethics committee in a hospital? Describe one situation that might require the…

A: An ethics committee refers to a group of individuals that are formed to protect or safeguard the…

Q: Intervention mapping model strengths and weaknesses

A: The objective of this question is to understand the strengths and weaknesses of the intervention…

Question

100%

Describe the risks of managed care and utilization review.

What are examples of legal actions that have resulted.
A review of the mechanisms that are in place to prevent such failures

Expert Solution

This question has been solved!

Explore an expertly crafted, step-by-step solution for a thorough understanding of key concepts.

SEE SOLUTION Check out a sample Q&A here

Step 1

VIEW

Step 2

VIEW

Step by step

Solved in 2 steps

SEE SOLUTION Check out a sample Q&A here

Similar questions

what is fixed cost and how is it applied in healthcare?
What type of guidelines would you place in a hospital or medical setting to avoid the grey and difficult decisions Clinicians sometimes have to make?
Apply relevant theories and concepts relating to the growth and development of strategic Human Resourse Management to specific examples in a hotel
Focusing on state and national organizations why is membership beneficial To a career in kinesiology?
Case Study – management working union jobs Dining service line cooks in your hotel have filed a grievance against you. They say that your hotel failed to abide by the conditions outlined in your collective bargaining agreement with their union. According to the employees, the Executive Chef has under-scheduled personnel in her department so that she and her Sous Chef can prepare the dinner meals themselves – thereby saving the department money. Employees filed a “performance of bargaining unit work” grievance asserting that the Executive Chef was taking away their work and attempting to eliminate their jobs. Discussion Questions 1.Do the line cooks in this work unit have a legitimate grievance? Describe why or why not. 2.How could this grievance be avoided? What position should management assume when presenting its side in this case?
discuss the key differences between conventional case management & disease management.
Chapter 5 Explain why smaller hospitals may wish to establish a single department to handle quality management and risk management. Describe the importance of physician support for risk management.
What kind of system is the NHS? What are its distinctive features?
How does Health Insurance shaped or changed the hospital industry?
Why the Community Services and Networking are important in Human services? What is Community service? what is Networking for human service?
What steps must be taken before creating a new healthcare facility?
What is the average total one-time cost fo a cancer program?