The Patient Protection and Affordable Care Act (PPACA) of 2010 brought many changes to the types of provider organizations available. Accountable care organizations (ACOs) and patient-centered medical homes (PCMHs) are two organizations formed under the PPACA. Both ACOs and PCMHs are models that are established to promote coordinated high-quality care at lower costs and improve patient outcomes. You must select either ACOs or PCMHs for this final paper.
For your Managed Health Care Delivery Models final paper, you must complete an eight- to 12-page paper.
In your paper,
Discuss the origin and structure of your selected managed health care delivery model.
Describe how your selected model has striven to contain the costs or improve the quality of care.
Summarize health care providers’ contracts and payment methods in your selected model.
Assess the impacts of your selected model on either Medicare or Medicaid.
Examine one specific public policy or regulation (e.g., PPACA) in relation to your selected model.
Evaluate the challenges or opportunities facing payers and providers in your selected model.
Create a plan of action to overcome identified challenges or take advantage of identified opportunities in the context of access, quality, and cost.
OUTLINE ATTACHED
PLEASE USE THE FOLLOWING REFERENCES:
Kongstvedt, P. R. (2020). Health insurance and managed care: What they are and how they work (5th ed.). Jones & Bartlett Learning.
Chapter 8: Laws and Regulations in Health Insurance and Managed Care
Hale, G., Moreau, C., Joseph, T., Phyu, J. Merly, N., Tadros, N., & Rodriguez, M. M. (2021). Improving medication adherence in an ACO primary care office with a pharmacist led clinic: A report from the ACORN SEED Download Improving medication adherence in an ACO primary care office with a pharmacist led clinic: A report from the ACORN SEED. Journal of Pharmacy Practice, 34(6), 888–893. https://doi.org/10.1177/0897190020934271
Jones, L. W. (2020). COBRA is 35 (almost); Requirements and compliance issues still vex employers Links to an external site.. Employee Relations Law Journal, 46(1), 85–90. https://doi.org/10.1177/10628606177029
Lofy, L. (2022). A new look at standing for ERISA causes of action in defined-benefit plans Download A new look at standing for ERISA causes of action in defined-benefit plans. Arizona Law Review, 64(1), 277–306.
Leung, L. B., Steers, W. N., Hoggatt, K. J., & Washington, D. L. (2020). Explaining racial-ethnic differences in hypertension and diabetes control among veterans before and after patient-centered medical home implementation Links to an external site.. PLoS ONE, 15(10), 1–10. https://doi.org/10.1371/journal.pone.0240306
HISTORY. (2018, May 16). Here’s why the Affordable Care Act is so controversial | History Links to an external site. [Video]. YouTube. https://youtu.be/ryxbnSqN2Xo
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