Posted: February 4th, 2016

develop a payer mix goal with objective referenced rationale based on utilization management for a healthcare organization of your choice (real or hypothetical).

Based on information in the text (Kongstvedt, 2013), Weeks’ 1-3 lecture notes (Oestmann, 2014), and research from at least 3 authoritative outside sources, write a 3- to 5-page paper that addresses the following:

As a health services manager with expert knowledge of managed care systems, insurance, and regulations, develop a payer mix goal with objective referenced rationale based on utilization management for a healthcare organization of your choice (real or hypothetical).

The payer mix should:

•Be reported in terms of percentages for each patient group receiving services at your specified organization
•Include pros and cons associated with your recommendation to address the recent loss in A/R (money coming in) based on the payer mix payment
•Be based on a list of 10 common services and corresponding payment structures (e.g., make one recommendation if your payer mix payment dropped 20 percent in one quarter)

Support your statements with evidence from the Required Studies and your research. Cite and reference your sources in APA style.