Posted: March 22nd, 2016
Answer the 5 questions presented below. The answers do not have to be lengthy just have to show the understanding of the concept. No references needed.
1. Until about the year 2000, managed care was viewed by many (mostly employers) as an effective means of controlling health care costs. Briefly address why there has been a backlash against HMOs over the past decade and address what steps HMOs have made to overcome these problems.
2. The Affordable Care Act has included managed care as a method of controlling health care costs. Consistent with #1 above, briefly address the future role of managed care under the ACA, especially as it relates to Covered California, our health care exchange.
3. The text (Kongstvedt) addresses a continuum of managed care plans. In southern California, a majority of employers offer HMO plans and PPO plans. Briefly descibe these two plans and discuss several major differences between them.
4. With the exception of Kaiser, most (if not all) HMOs operating in California contract with hospitals, physicians and other health care providers rather than owning hospitals or medical groups. Briefly explain the difference between an Independent Practice Association (IPA), a group model medical group, and a staff model medical group.
5. The Affordable Care Act (ACA) includes provisions for Accountable Care Organizations (ACO) and Patient Centered Medical Homes. What are these entities and how may they be related to managed care?
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