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Managed Care Readiness

LP8 Assignment: Managed Care Readiness
The assignment assesses competency 8. Examine the managed care concept in the workplace.
Directions:
Managed Care Readiness
After reviewing the Table 27-3 in Chapter 27, detail how Canada can apply managed care readiness characteristics to their current health care system based on the following:
Overall system structure:
• Detail the extent of control that the central or regional government exerts over the health care system’s day-to-day management and care processes.
• Assess the extent to which private plans or organizations play a largely independent role relative to the government in Canada as the main source of coverage.
Consumers:
• Describe the degree to which consumers have significant alternative options with respect to their primary health insurance plan and system of care.
• Assess the ability of patients to choose their provider at the time they seek care.
Providers:
• Describe the degree of provider integration between primary and specialty care, and between ambulatory and hospital care. The level of integration affects efficiency and effectiveness of health care.
• Assess the extent to which financial incentives and controls are targeted at clinicians in support of efficient and effective practice.
Managed Care:
• Detail if public health and epidemiologic principles are applied in conjunction with economic incentives to maximize benefits across the society or to the enrolled group.
• Assess the use of various methods to actively manage utilization in differing populations (Utilization Review, disease management, case management programs).
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LP8 Assignment: Managed Care Readiness The assignment assesses competency 8. Examine the managed care concept in the workplace. Directions:Managed Care ReadinessAfter reviewing the Table 27-3 in Chapter 27, detail how Canada can apply managed care readiness characteristics to their current health care system based on the following: Overall system structure:• Detail the extent of control that the central or regional government exerts over the health care system’s day-to-day management and care processes.• Assess the extent to which private plans or organizations play a largely independent role relative to the government in Canada as the main source of coverage. Consumers:• Describe the degree to which consumers have significant alternative options with respect to their primary health insurance plan and system of care.• Assess the ability of patients to choose their provider at the time they seek care. Providers:• Describe the degree of provider integration between primary and specialty care, and between ambulatory and hospital care. The level of integration affects efficiency and effectiveness of health care.• Assess the extent to which financial incentives and controls are targeted at clinicians in support of efficient and effective practice. Managed Care:• Detail if public health and epidemiologic principles are applied in conjunction with economic incentives to maximize benefits across the society or to the enrolled group.• Assess the use of various methods to actively manage utilization in differing populations (Utilization Review, disease management, case management programs).

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