The purpose of the Session Long Project is to evaluate quality for managed care organizations and hospitals. The following resource should help you when accessing quality report cards.
Health and Human Services Website:
In Module 1, please explain how Health and Human Services formulates its quality ratings for hospitals. Consider at least one advantage and one disadvantage of this published information.
As identified above, in Module 1, please explain how Health and Human Services formulates its quality ratings for hospitals. Consider at least one advantage and one disadvantage of this published information.
Use information from the modular background readings as well as any good quality resource you can find. Cite all sources and provide a reference list at the end of your paper.
Blumenthal, D., Chernof, B., Fulmer, T., Lumpkin, J., & Selberg, J. (2016). Caring for high-need, high-cost patients—an urgent priority. New England Journal of Medicine, 375(10), 909-911.
Bridger, C. M., Smith, S. E., & Saunders, S. T. (2017). Saving lives and saving money: The role of North Carolina health departments in Medicaid managed care. North Carolina Medical Journal, 78(1), 55-57.
Cleverley, W. O., & Cleverley, J. O. (2017). Essentials of health care finance. Jones & Bartlett Learning.
Hines, A. L., Raetzman, S. O., Barrett, M. L., Moy, E., & Andrews, R. M. (2017). Managed care and inpatient mortality in adults: Effect of primary payer. BMC Health Services Research, 17 doi:10.1186/s12913-017-2062-1
Keast, S. L., Skrepnek, G., & Nesser, N. (2016). State Medicaid programs bring managed care tenets to fee for service. Journal of Managed Care & Specialty Pharmacy, 22(2), 145-148.
Mahmoudi, E., Tarraf, W., Maroukis, B. L., & Levy, H. G. (2016). Does Medicare managed care reduce racial/ethnic disparities in diabetes preventive care and healthcare expenditures? The American Journal of Managed Care, 22(10), E360.
McGinnis, T., Houston, R. & Brown, D. (2013) The balancing act: Integrating Medicaid accountable care organizations into a managed care environment. Center for Health Care Strategies: Issue Brief. Retrieved from: https://www.chcs.org/media/ACO111313_Final.pdf
Richard, D. (2017). What is next for behavioral health in managed care? North Carolina Medical Journal,78(1), 30-32. doi:10.18043/ncm.78.1.30.
Schafer, J., Galante, D., & Shafrin, J. (2017). Value tools in managed care decision making: Current hurdles and future opportunities. Journal of Managed Care & Specialty Pharmacy.
Thompson, B. & Robbins, A. (n.d.) Understanding managed care. Washington State DSHS. Retrieved from: https://www.dshs.wa.gov/sites/default/files/BHSIA/dbh/Integration/Webinar%20Understanding%20Managed%20Care.pdf
Uriarte, J. (2015, August 10). 6 Dimensions of Healthcare Quality [Video file]. Retrieved from https://www.youtube.com/watch?v=QexTk38euzY
Walters, T., Parcher, B., Kravetz, A., Campbell, C., Shah, M., & Hale, T. (2016). Appraising the value of digital health technologies from the managed care perspective: Insights for evidence assessment and reimbursement in the United States. Journal of Medical Internet Research, 18(12).
Wang, Tze-Fang; Shi, Leiyu; Nie, Xiaoyu; Zhu, Jinsheng. (2013). Race/ethnicity, insurance, income and access to care: The influence of health status. International Journal for Equity in Health, 12(1), p.29
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