You are the new CFO, of UMUC 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 addresses 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:     
  • 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.
•  Submit one (1) single Microsoft Word document

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Assignment Overview

There are various types of plans consumers can select. MCOs, HMOs, PPOs, POSs, or ACOs are the most common ones; however they all supply various benefits and drawbacks. Consumers (patients) have the right to choose the type of plan that best fits their needs. In fact, health care is a consumer-driven industry and as health care costs have continued to increase, consumer-driven health plans (CDHP) have become the next new thing (after managed care) (Fronstin & MacDonald, 2008). As a health care leader, it is vital that you understand the differences in these plans.

Fronstin, P. & MacDonald, J. (2008). Consumer- Driven Health Plans: Are they Working. Retrieved from http://online.wsj.com/ad/employeebenefits-consumer_driven_plans.html

Case Assignment

For the Module 2 Case Assignment, conduct additional research as needed and prepare a 3- to 4-page comparative essay. Your comparative analysis should include a detailed comparative chart (see example at the following source: https://philsblogspace.files.wordpress.com/2012/10/eco-chart.jpg?w=1400). In your comparative analysis and chart, you are to evaluate and discuss:

1. The key features, differences, and disadvantages between MCOs, HMOs, PPOs, POSs, and ACOs.
2. The key features of a Consumer-Driven Health Care Plan (CDHP).
3. The future of CDHPs, MCOs, HMOs, PPOs, POSs, and ACOs.

You are to support your analysis and views with at least four scholarly references (i.e., peer-reviewed journal).

For additional information on how to write a comparative analysis, review the following source: https://writingcenter.fas.harvard.edu/pages/how-write-comparative-analysis

Assignment Expectations

1. Conduct additional research to gather sufficient information to justify/support your proposal.
2. Limit your response to a maximum of 4 pages.
3. Support your proposal with at least 4 peer-reviewed articles. Use the following link for additional information on how to recognize peer-reviewed journals: http://www.angelo.edu/services/library/handouts/peerrev.php.
4. You may use the following source to assist in your formatting your assignment: https://owl.english.purdue.edu/owl/resource/560/01/.

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Write an argumentative research paper on a managed care-related topic, assumption or myth; thoroughly explaining what it is, why it’s important, and how it fundamentally impacts the managed care system today. You will gather evidence on present a well-reasoned argument or debatable issue. The goal of an argumentative paper is to show that your perspective is valid. You are to form reasons, draw conclusions and apply them to your findings. The purpose is not to completely prove your point, but to convince readers, with your evidence, that your argument or position has merit.

You will be evaluated according to your topic selection, thesis and outline, annotated bibliography, peer review, and final paper delivered in proper format as follows:

ASSIGNMENT

 Present “a managed care-related topic, thoroughly explaining what it is, why it’s important, and how it fundamentally impacts the managed care system today.”

• Presents an argumentative paper with reasoning and evidence of debatable issue.
• Incorporates suggestions as needed from peer review.
• Incorporates key elements of a quality research paper:
  • Strong thesis statement that states the main point of your project and suggests the path that your project will follow.
  • Attention-getting introduction moving into quick transition that leads into thesis. Captures readers’ attention.
  • Topic sentences relate back to thesis statement. All information is relevant to thesis.
  • Logical transitions between paragraphs and ideas provide unity and coherence to the whole. Clear organization.
  • Concluding paragraph sums up information and reiterates thesis.
• Mechanics follow required standards. (Spelling, grammar, sentences written according to Standard English.)

Technical Requirements

An original research paper with a body of 6-8 pages. In general, your paper should consist of the following pages:

Title Page – captivating title, your name, title of the course, date

Body – 6-8 pages of introduction, background on your topic, research support, personal evaluation, strong conclusion. Body should be organized with a minimum of the following titles

• Introduction
• Thesis or Position
• Reasons
• Objections
• Support of Responses
• Conclusion

References Cited page – in APA format.

Research and Writing Requirements include:

1. Proper mechanics: clear, concise, complete sentences and paragraphs, proper spelling, grammar and punctuation. 
2. Five or six sources for the paper from your research.  Internet resources should be reliable as at a university or government website. Use statements and ideas that you have come up with on your own and blend these in with your research. Do not plagiarize. If you want to use actual words from a source, put them in quotation marks with the source.

Follow APA format for citing your sources.

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 Must have reference. Must develop a question for the class at the end of the writing. Do not forget to include the question or reference. 

280-word message in which you answer the following questions:

• What role does managed care play in health care? How has this role led to increased racial and economic disparity in health care in the United States?
• What are you, as a nurse practitioner, going to do to overcome the limitations as they relate to the health care delivery system that currently exists?
• What are the most used modes of health care delivery in the United States? Are these modes affected by racial and economic disparity?
• How has managed care influenced the various modes of health care delivery?

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As a current or aspiring healthcare manager, why do you feel you might need to understand managed care plans.

Must be 200 words. No references or citations are necessary.

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