BHS 459 Module 2-SLP: Managed Care

Module 2 - SLP

MANAGED CARE 

Watch the following video in preparation for this assignment:

Accreditation Association for Ambulatory Health Care (AAAHC). (2010). Introduction. Retrieved from

Use what you learned from the video, the module’s required readings, and your own research to answer the following questions in your paper.

• Discuss the purpose of accreditation. Has the process of accreditation really improved the quality of care being provided to patients?
• Identify and discuss the process of accreditation for the chosen agency.
• Discuss some of the standards they look for when they go on-site. Are the standards rigorous or vague?
• Do these agencies make the results of their surveys public? How could knowing this information be beneficial to patients?

Length: Submit a 3-page paper.

Required Reading

Ash, A. S., Mick, E. O., Ellis, R. P., Kiefe, C. I., Allison, J. J., & Clark, M. A. (2017). Social determinants of health in managed care payment formulas. JAMA Internal Medicine, 177(10), 1424-1430.

Bachrach, D., Guyer, J., Meier, S., Meerschaert, J., & Brandel, S. (2018). Enabling sustainable investment in social interventions: A review of Medicaid managed care rate-setting tools. Retrieved from https://www.commonwealthfund.org/publications/fund-reports/2018/jan/enabling-sustainable-investment-social-interventions-review

Bindman A. Redesigning Medicaid managed care. (2018). Journal of the American Medical Association, 319(15), 1537–1538. doi:10.1001/jama.2018.3411

Brady, M., & Teooer, N. (2021). Biden reopens ACA enrollment, will revisit Medicaid work requirements. Modern Healthcare (1976), 51(5), 6. Available in the Trident Online Library.

Brown, C. (2018). Recognition of family physicians as experts rather than gatekeepers requires "cultural shift". Canadian Medical Association Journal, 190(17), E550-E551. Available in the Trident Online Library.

Dumontet, M., Buchmueller, T., Dourgnon, P., Jusot, F., & Wittwer, J. (2017). Gatekeeping and the utilization of physician services in France: Evidence on the médecin traitant reform. Health Policy, 121(6), 675. doi:10.1016/j.healthpol.2017.04.006

Hines, A. L., Raetzman, S. O., Barrett, M. L., Moy, E., & Andrews, R. M. (2017). Managed care and inpatient mortality in adults: Effect of primary payer. BMC Health Services Research, 17(1), 121.

Lotven, A. (2021). Health care executives order kick off ACA policy making spree. InsideHealthPolicy.Com’s Health Exchange Alert, 9(5). Available in the Trident Online Library.

Ndumele, C. D., Schpero, W. L., Schlesinger, M. J., & Trivedi, A. N. (2017). Association between health plan exit from Medicaid managed care and quality of care, 2006-2014. Journal of the American Medical Association, 317(24), 2524-2531.

Shi, L., & Singh, D. A. (2017;2019). Delivering health care in America; A systems approach (7th ed.) Jones & Bartlett Learning, LLC. Available in the Trident Online Library.

Stew Kaufman, M. B. A., & Hughes, J. (2017). The current status of outcomes-based contracting for manufacturers and payers: An AMCP membership survey. Journal of Managed, 4, 410.

Tandjung, R., Morell, S., Hanhart, A., Haefeli, A., Valeri, F., Rosemann, T., & Senn, O. (2017). Referral determinants in Swiss primary care with a special focus on managed care. PLoS One, 12(11) Available in the Trident Online Library.

Yeung, K., Suh, K., Basu, A., Garrison, L. P., Bansal, A., & Carlson, J. J. (2017). Paying for cures: How can we afford it? Managed care pharmacy stakeholder perceptions of policy options to address affordability of prescription drugs. Journal of Managed Care & Specialty Pharmacy, 23(10), 1084-1090.