Topic 5: Managed Care Organizations and Integrated Health Care Networks

Assignment/Task: Reflective Analysis: Risk Management and the Role of Managed Care

The purpose of this assignment is to analyze the role of managed care organizations within health care and risk management programs.

Reflect on and evaluate the role that the managed care organization (MCO) plays in today's health care environment by developing a 250-500 word response that addresses the following:

1. What is a health care organization's administrative role in executing risk management policies and ensuring compliance with managed care organization (MCO) standards?
2. What value do the regulatory statutes of a typical MCO provide to a health care organization? Consider how strategies pertaining to policies such as conflict resolution and risk management affect patients as well as employees and employers.
3. What MCO responsibilities relevant to the Patient Protection and Affordable Care Act (ACA) and Center for Medicare and Medicaid Services (CMS) focus on fraud, waste, and abuse laws?

In addition to your textbook, you are required to support your analysis with a minimum of two peerreviewed references.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.