WK1A3: Please use APA format and list and site all sources and references: 2- to
ID: 122000 • Letter: W
Question
WK1A3:
Please use APA format and list and site all sources and references:
2- to 3-page Microsoft Word document
You have been presented an outstanding opportunity to serve as a graduate student intern for the chief executive officer (CEO) of a large HCO. The HCO is an HMO model and originated approximately a century ago as a small rural hospital. Due to the rural setting, the HMO model flourished and, over the years, expanded throughout the region. Today, the HMO has a presence in over eighteen counties and has a number of competing interests from for-profit and not-for-profit HCOs in the region.
The board of directors recently approved the acquisition of two regional hospitals. First, the HCO decided to acquire a small rural critical-care-access hospital in a relatively remote county. The interest in acquiring the hospital is to service the existing population and expand the reach of the HMO. Second, the HCO decided to acquire a private full-service hospital in a moderate-size city (population forty-two thousand). The HCO’s move is strategic in nature, preventing the sale of the hospital to its for-profit competitor, and will gain the region its sole emergency department level 2 (two) trauma center with helicopter transport while giving the HCO the ability to service its growing HMO membership in the area.
Based on the above information:
Evaluate the various HMO models (staff, group, and network) and identify the model that would probably be best suited for the region. Justify your answer.
Research and comment on the importance and applicability of the various levels of emergency department trauma care. Investigate the exemptions afforded to a critical care rural hospital with respect to Medicare reimbursement and accreditation.
Elaborate on the difference between an HMO and an accountable care organization (ACO).
Explain the concept of capitation, its importance to the HMO and participating providers, and how the concept of capitation varies with the ACO model.
Explain patient-centered care and its importance in healthcare delivery
Please use APA format and list and site all sources and references:
2- to 3-page Microsoft Word document
Explanation / Answer
HMO: HMO means Health Maintainence Organisation .it is a medical isurance which provides health care to its members through a annual fees.It was mandated by HMO Act in 1973 with atleast 25 employees who provide tradition health care.The members of HMO will select a person as a primary health care provider who guides the health care services.Members can get care from predetermined list of hospitals and doctors.It has got negative feedback from public over many years.
ACO:Based on many drawbacks from HMO it has been introduces as a part of the Patient protection and Affordable Care Act in 2009.It is also known as Accountable Care Organisation where health care professionals held up responsibility for bringing health care to the members.the health care provider is reimbursed payment acoording to the quality of treatment recieved by the members.Here the primary health care provider tracks and keep the records of the patients and shares the information with other health team members.
COMPARISON BETWEEN HMO AND ACO: HMO is a medical insurance which provides health care to any member certained with anual fee.Where as ACO is networked health care professionals who makes sure that the quality of health is provided to the members.
PATIENT CENTERED CARE:The care is provided to the patients in a meaningful way and valuable which includes listening to, informing and involving the patients in their care.there are some principles in patient centered care they are-respect for patient preferenceses -asses care -coordination and integration of care -physical comfort,emotion support,information and education,involvement of family members, continuity of care.
IMPORTANCE OF PATIENT CENTERED CARE:To improve the quality of services,to help the people get care what they needed and when needed,to help people more active in looking after themselves,to reduce pressure upon the health and other social services,
HMO ACO medical insurance organisation group of networked health care professional primary health care provider acts a gate keeper to all predertermined list of hospitals primary health care provider charges over the health team members members cannot choose doctor or any additional treatment members can choose any health care provider as well as any additional treatment medical cost is deciding factor improved medical serviceRelated Questions
Navigate
Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.