Paper: “Utilization Review”.

Directions

PAPER: “Utilization Review Video”.

First review the video. This will help you with the assignment.

• Utilization Review Assignment.
• Your assignment is to write a 2-3 page paper. Describe first the standards or criteria of each. Second how you would enforce or what incentives you would create to encourage physicians to follow those standards for each of the three areas. The three areas again are; physician time with patients, the ordering of tests, particularly blood tests and x-rays, and third the referral to specialists. That’s all there is to it.
• 2.PAPER: “Medicaid and HMO”
  

  Directions

  PAPER: “Video” .

  First review the video. This will help you with the assignment.

  • Assignment: Should Medicaid and HMOs join forces?
  • Write a 2 – 3 page paper in what you find out about whether or not the HMO’s representative claims were correct. Does an HMO, enrolling Medicaid patients promise; one, cost efficiency and two improvements in quality of care? One site you can get started is www.nber.org. There are many other sites you can look at to get data about this. So that’s your assignment. Good idea? Bad idea and why? Back it up with some good data. That’s all there is to it. Good Luck!” .

  Consider:

  • Would the state save money by enrolling members in an HMO?
  • What would happen to the quality of care?

  Please cite references.