2017 Health Insurance Plans Managed Care Organiza

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2017 Health Insurance Plans Managed Care Organiza

I am working on a group project with my team and I am responsible for only the following portion and need help in writing it:

  • Supported by scholarly literature, conduct a one (1) page analysis of the ACA and its future implications on managed care organizations (in particularly in reference to reimbursement)

Please review the directions below. The analysis should be 1 page single spaced with APA citations/references

“Contracts Review”

You are the new CFO, of XYZ Medical Center, a 120 multi-skilled level three (3) healthcare facility. You have summoned a team of healthcare and business experts to assist with the process of contract negotiating. Based on the federal mandate of the Affordable Care Act (ACA), prepare a proposal summarizing the team’s final recommendations in preparation for an upcoming meeting.

Devise a proposal that address the following:

  • Present a four to five (4-5) page proposal recommending the team’s final decision based on the review of National Committee on Quality Assurance (NCQA), 2016-2017 health insurance plans rating that can be located directly at http://healthinsuranceratings.ncqa.org/2016/Default.aspx. The proposal must identify the following
    • Supported by scholarly literature, conduct a one (1) page analysis of the ACA and its future implications on managed care organizations (in particularly in reference to reimbursement)
    • Create a one (1) page checklist that will be utilized as a tool to review managed care contracts presented to the organization.
    • A one year (1) financial analysis as a predictive measure/tool projecting the financial performance based on the adoption of the selected health plan and reimbursement model [based on fictitious data and figures]
    • Identify at minimum three (3) involved parties the team recommends as a contributing player in the review of all managed care contracts under consideration. Briefly support your reasoning for each recommended person to participate in the review.
    • Share the team’s final review of the contract, XYZ Medical Center has received for consideration. In addition, provide a final recommendation as to the selection of the primary managed care organization. In addition, discuss whether the contract should or should not be accepted, and the logic for the recommendation. The contract template can be located directly at https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Practice%20Management/Office%20Operations/sample_managed_care_contract.pdf )