Based on Chapter 7-10, answer the following questions and be sure to follow the Discussion Board & Assignment Instructions 300 words Kongstvedt, Essentials of Managed Care, Sixth Edition ISBN: 978-1-4496-5331-6
You are the Managing Director reporting to the CEO on updates and concerns on the day-to-day business at Greys Medical Center. You are responsible for the smooth functioning of daily processes and oversee the managers and other department heads in the company.
- Discuss the types of data and reports that would be useful to the medical director for managing specialist utilization
- Explain how this might differ in different types of plans.
- Explain the key differences between conventional case management and disease management and provide examples of each.
- Lastly, develop policies and procedures for a physician sanction program to deal with unacceptable physician behavior using your own experience as an example.
Read: Case-Studies-Medicaid-Managed-Care.pdfActions and complete the following case study assignment.
You are a Nurse Manager in a low-income neighborhood at Greys Medical Center. Plagued with an influx of hepatitis C patients, you call your Chief Nursing Officer to discuss your concerns. She calls a meeting to order with several key players in an effort to discuss case management, care coordination, rapid treatment initiation, and other services that, historically, have lacked robust infrastructure in the hepatitis C space. In addition to cost-related factors, she is looking to put a plan in place to emphasize the importance of all public health benefits of ensuring members are cured as she is aware surrounding states are working towards eliminating hepatitis C in their jurisdictions. With, all other health concerns attached to the virus, and most of the patients being Medicaid aided patients, she asks you to put together a team to help with further educating the community to help in preventing the spread. She asks you to lead in putting together a treatment plan for those living with Hep-C and assist the team in lowering the infection rate in the communities plagued by this virus? Create a plan and present it for credit.