Managed Care Paper: This counts for 20% of your grade (200 points) and will serve as your final exam. Each student will write a 3-page paper (not including a cover page and/or references). It must be double spaced, 12 point font, MS Word format. The topic will be on CURRENT issues in managed care and how it relates to the scenario below. At least five reference sources must be used which includes the Kongstvedt textbook. Try to avoid or limit web resources that have no references.
Scenario:
The city of Tascosa has a population of 200,000 plus. The Tascosa school district has over 3,000 employees. They want to negotiate a managed care contract with a local non-profit hospital so they can provide their own health insurance, in other words, be self-insured. The hospital is a full service hospital with a trauma level emergency room and ancillary services. It has a large primary care (family practice) and a multi-specialists group practice in their network.
In your paper, describe how they should address:
Member services, including enrollment, claims processing, complaints and appeals of coverage.
Utilization management, including disease management, case management and pharmacy benefits.
Provider payment.
Any other items that you want to highlight.
Your paper will be graded on:
1) Organization – introduction, paragraph format, typos/grammar, body and conclusions, etc…
2) Content – How well did you state your message? How complete is the presentation of the message? Is the message supported by references and examples of your knowledge of the subject matter?
As stated in my welcome to all of you, “The goal of this course is to stimulate your inquisitiveness to steer your organizations’, to surpass the evolving healthcare space. Think entrepreneurial…” I am confident, through the readings, discussions, and supplemental videos you will develop a foundation of innovation and entrepreneurship to apply towards changing the canvas of medical care, into the future. So let’s start now and have some fun with this project..be creative, out-the-box, futuristic in designing your idea.
Your final project will be a 5-page paper in which you design a product or service:
Explain the need for your product or service
Describe your product or service in detail
Illustrate how you will market your product or service
Create a budget for your product or service to include if you will be relying on investors (be creative, I don’t expect exact numbers) estimate
Discuss your plan to evaluate the success of your product or service
Requirements:
Minimum 5 pages
Double-spaced
Times-News Roman Font
12-pitch
Include a Title Page, Heading or Bibliography (not included as part of the 5 pages)
Students will use APA format
Submit in the assignment tab titled: Final Project HPHM 4337
HPHM 4337 PROJECT RUBRIC
Part One. Project Relevance and Need (1.5 pages)
Points: 100 points
Describe why your product or service is needed
Provide the evidence to support the need for this product or service (e.g. research evidence/statistics)
Part Two. Project Description (2 pages)
Points: 100 points
Provide a description of the proposed project
Provide the objectives/goals of the project
Describe the target audience(s) for the project
Part Three. How will Market the Product or Service (.50 page)
Points: 25 points
The media outlets
The audience(s)
Part Four. Budget (.50 page)
Points: 20 points
Do you have R & D costs? How much?
Production costs?
Marketing costs?
Investors?
Part Five. Evaluation of Product or Service (.50 page)
Points: 25 points
Discuss your plan to measure/evaluate the success of your product or service
Timeline
Other Grading: Title Page, APA Format and References
Point: 30 points
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