Essay Example on Discuss the recent trends in HMO PPO and ACO Development

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Directions Please follow these directions as failure to do so will result in severe deductions from your grade 1 Write your responses in your own words in sentence format to the questions below utilizing information from the book NOTE Do not use bullet points numbering or lettering systems unless specified Failure to do so will result in a loss of points from your assessment 2 Please make sure that you are using proper grammar check spelling and punctuation and when applicable use citations and references Points will be deducted for grammar and punctuation errors 3 Be sure that your assessment is at or below the Turnitin similarity of 50 as failure to do so will result in a loss of points Greater than 50 Above 50 means that you wrote verbatim i e word for word from a source and or you did not provide an adequate discussion A Adequate reimbursement levels are an important consideration in the strategic planning process Discuss the recent trends in HMO PPO and ACO development and the impact they have on strategic planning The recent trends HMOs have developed over the years is that they contracted with certain type of physicians hospitals and other health care providers to provide critical medical services to patients Health Maintenance 



Organization allows patients to receive medical services from certain hospitals and doctors within its own network There might be a few opportunities where patients may allow to receive treatment from non network providers but those patients will have to pay higher deductible and copayment One of the most recent trends in HMO is that it allows patients to choose a primary care physician The physician will determine what type of treatment the patients need The high cost to receive treatment is another trend in HMO Patients who have chronic diseases will eventually use more services which results in higher cost for treatments In addition HMOs have strict limitation on the number of visits HMOs have impact on strategic planning where they control the cost of treatment They also reduce a huge amount of redundant medical services which can perform by the patients Unlike HMOs the recent trends in PPOs is that they allow patients to receive health care services from out of network health providers and it is not required for clients to have referrals to see other providers within the network however they will have to pay higher premiums and a larger percentage of what the provider charge them Lastly ACOs provides medical services by a group of health care providers which includes hospitals doctors etc


The recent trends in ACOs are that they ensure that patients receive high quality of care ACOs have impact on strategic planning by providing health safety and efficiency to patients which reduce the cost to receive treatment and it also decreases unnecessary medical services to the populations B Coastal Medical Center Case Study Question s 1 Does the board hold management accountable for achievement of the strategic plan If so how If not why No the board doesn t hold management responsible for achievement of the strategic plan because the CEO is the one who makes most of the decisions but the ideas come directly from the managers The CEO tells the managers what to do and grasp their ideas without evaluating them In addition the board felt that the CEO should have contacted them before implementing new plans which could have been resulted in better strategic planning That is one of the reason they fired only him because the facility revenue dropped excessively 2 In the comprehensive case study the original CEO provided leadership to a highly successful healthcare organization for over 20 years and was considered a visionary Develop a list of five areas in which you think the original CEO s performance was particularly outstanding Engagement communicator Commitment Strategic planning Leader and Vision are the five area I think that the original CEO s performance was particularly outstanding Mr Wilson was a good communicator and he used it to make the facility become successful Unlike Mr Henderson who sits back and imply others what to do Mr Wilson engaged with his staff and patients Secondly he committed to the facility for 12 years to make it what it is today In addition He used visionary to transform the medical center from tertiary care facility to high intensity care which included liver kidney and heart surgery transplantation where patients can get better medical services Harrison pg 4 His strategic planning when it comes to financial decision was outstanding because the facility revenue have been grown ever since he came into office Finally he used leadership to improve the delivery of health care services within the facility he sets goals and makes sure those goals were being met no matter the cost APA References Harrison J P 2016 Essentials of strategic planning in healthcare Chicago IL Health Administration Press


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