managed health care 2

The purpose of this project is to determine how managed care organizations (MCO’s) define, measure and report on “Quality” to the public, their enrollees and participating providers.

Logistics: Students will be expected to write a full explanation of each section. This assignment is worth 50 points. Roughly 10 points per section and another 10 points for overall impression.

Directions:

1. Source: National Committee on Quality Assurance web site (www.ncqa.org).

How does NCQA define quality?

Define HEDIS

Look under “Performance Measures” and choose 5 HEDIS measures and provide a full explanation of each

What is CAHPS

What is PCMH

2 .Regarding the Health Plan Report Card -also NCQA.org

Within the NCQA website, locate the “Newsroom” Tab and select “The State of Health Care Quality Report”; then “Health Plan Report Card”. Select “Indiana” and “commercial insurance”. This will take you to a listing of plans in Indiana. Select two health plan from those listed that you wish to evaluate and compare

For each plan chosen; what are the 5 categories that are rated by stars for each plan and what star rating did these plans achieve for each category? What is the plan’s overall accreditation?

Define what each star-rated category means.

3. Source: https://qpp.cms.gov/

Compare MACRA versus MIPS

4. Summarize your findings

Is the NCQA “STAR” rating system an acceptable method for assessing/reporting quality from a consumer viewpoint?

Would the NCQA “star” rating make a difference to you when choosing a health plan?

What extra costs (premium) would you pay for a “higher quality” health plan?

 

Do you need a similar assignment done for you from scratch? We have qualified writers to help you. We assure you an A+ quality paper that is free from plagiarism. Order now for an Amazing Discount!
Use Discount Code "Newclient" for a 15% Discount!

NB: We do not resell papers. Upon ordering, we do an original paper exclusively for you.