Devry HSM420 2019 November All Weeks Discussions Latest

HSM420 Managed Care and Health Insurance

Week 1 Discussion

MANAGED CARE IMPACTS

There can be no doubt that managed care has impacted everyone involved with healthcare delivery in America. What do you see as some of the most significant impacts of managed care for patients?

 

HSM420 Managed Care and Health Insurance

Week 2 Discussion

PROVIDER NETWORKS AND LEGAL ISSUES IN PROVIDER CONTRACTING

Why do managed care organizations seek to establish a provider network? What are the primary reasons for contracting with providers?

 

HSM420 Managed Care and Health Insurance

Week 3 Discussion

CASE MANAGEMENT VERSUS DISEASE MANAGEMENT

A definite trend in US managed care is the move to Disease Management (DM) for patients with chronic diseases and long-term conditions. What exactly is Disease Management? Provide some examples of diseases which may benefit well from a DM model of care.

 

HSM420 Managed Care and Health Insurance

Week 4 Discussion

MANAGED CARE PHARMACY BENEFITS AND BEHAVIORAL HEALTHCARE

In managed behavioral healthcare, the Case Manager role is absolutely crucial. How would you describe this Case Manager role for behavioral health clients?

 

HSM420 Managed Care and Health Insurance

Week 5 Discussion

MANAGED CARE ACCREDITATION AND MARKETING

Discuss the managed care accreditation process. Do you feel that accreditation is important for managed care organizations? Why or why not?

HSM420 Managed Care and Health Insurance

Week 6 Discussion

UNDERWRITING, RATING, FRAUD AND ABUSE

Discuss fraud and abuse in healthcare. Provide at least three specific examples of fraudulent practices that have taken place in U.S. healthcare, and describe ways to prevent these in our modern healthcare environment.

 

HSM420 Managed Care and Health Insurance

Week 7 Discussion

STATE AND FEDERAL REGULATION AND PATIENT PROTECTION

Discuss health insurance regulation in the United States, being sure to include both state and federal regulations. What happens in the event that state and federal health insurance regulations conflict?