Managed Care Organization

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part 1

read Chapters 16 and 22 For your this part address the following 300 word

  • Describe the sales process in the employer-sponsored model.
  • Compare the differences between rating and underwriting.
  • Discuss the influence of the Patient Protection and Affordable Care Act on ONE of the four areas: (a) marketing, (b) sales, (c) rating, and (d) underwriting.

Part 2

read Chapter 23 of the course text. Part 2 address the following 300 word

  • Describe the information systems functionalities in claims management and member services maintained by Managed Care Organizations (MCOs).
  • Identify the significance of information systems in maintaining provider network operated by MCOs.
  • Discuss the changes in information systems to support consumerism that can be recognized in MCOs.
 
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