Devry HSM420 2019 November Full Course Latest

HSM420 Managed Care and Health Insurance

Week 1 Discussion

MANAGED CARE IMPACTS

There can be no doubt that managed care has impacted everyone involved with healthcare delivery in America. What do you see as some of the most significant impacts of managed care for patients?

 

HSM420 Managed Care and Health Insurance

Week 2 Discussion

PROVIDER NETWORKS AND LEGAL ISSUES IN PROVIDER CONTRACTING

Why do managed care organizations seek to establish a provider network? What are the primary reasons for contracting with providers?

 

HSM420 Managed Care and Health Insurance

Week 3 Discussion

CASE MANAGEMENT VERSUS DISEASE MANAGEMENT

A definite trend in US managed care is the move to Disease Management (DM) for patients with chronic diseases and long-term conditions. What exactly is Disease Management? Provide some examples of diseases which may benefit well from a DM model of care.

 

HSM420 Managed Care and Health Insurance

Week 4 Discussion

MANAGED CARE PHARMACY BENEFITS AND BEHAVIORAL HEALTHCARE

In managed behavioral healthcare, the Case Manager role is absolutely crucial. How would you describe this Case Manager role for behavioral health clients?

 

HSM420 Managed Care and Health Insurance

Week 5 Discussion

MANAGED CARE ACCREDITATION AND MARKETING

Discuss the managed care accreditation process. Do you feel that accreditation is important for managed care organizations? Why or why not?

HSM420 Managed Care and Health Insurance

Week 6 Discussion

UNDERWRITING, RATING, FRAUD AND ABUSE

Discuss fraud and abuse in healthcare. Provide at least three specific examples of fraudulent practices that have taken place in U.S. healthcare, and describe ways to prevent these in our modern healthcare environment.

 

HSM420 Managed Care and Health Insurance

Week 7 Discussion

STATE AND FEDERAL REGULATION AND PATIENT PROTECTION

Discuss health insurance regulation in the United States, being sure to include both state and federal regulations. What happens in the event that state and federal health insurance regulations conflict?

 

HSM420 Managed Care and Health Insurance

Week 4 Assignment  

Do you understand the workings of health insurance in the United States? This assignment will give you an opportunity to demonstrate the knowledge acquired so far. Please respond to all of the questions below in a word document. Each correct and complete response is worth 20 points. Make sure to type the questions and the answers in order.

Why were the first health insurance organizations formed in America? What were the original driving factors? Describe the early growth of health insurance in the US.

Explain the theory of insurance, by specifically addressing the degree of risk aversion, the size of the potential loss, and the "wealth effect".

What is meant by the "HMO Effect" versus "Favorable Selection" in managed care? Describe the evidence of an HMO Effect, and the evidence of Favorable Selection.

What are deductibles? Why are they so important in US health insurance models? How do changes in deductibles impact utilization and clinical decision-making.

Discuss the Utilization Management function in managed care, including Preadmission Certification and Concurrent Review of services.

Discuss the emerging role of Disease Management (DM) and Intensive Case Management in American managed care. How does DM actually work?

A key concept of health insurance is premium sensitivity. Describe the general process for premium computations in US healthcare insurance. Briefly explain employee premium sensitivity and how do employees typically respond to changes in health insurance premiums?

Describe the commonly used approaches to "underwriting" for healthcare services.

Do hospitals actually have "monopoly power" today? Why or why not?

Explain risk adjustment in the Affordable Care Act. How well does this approach work in your view?

Please submit your assignment. 

This assignment should be a minimum of two pages in length not including the title and references pages.

Your similarity is to be 15% or less make sure you review your similarity score that is acceptable.  DO NOT USE DIRECT QUOTES.  This is to be in your OWN WORDS and thoughts!

 

HSM420 Managed Care and Health Insurance

Week 2 Assignment  

Objectives

This HSM420 Course Project provides you with an opportunity to work in a team environment to select one important health insurance, managed care, or healthcare reform challenge (or problem to solve), analyze it in greater depth in a written format, and summarize it in a presentation.

Team Formation:

During Week 1, your instructor will divide the class into small groups of three or four students. Introduce yourselves and set up group messaging on WhatsApp or in the course shell. (You can initially email each other through the course shell to exchange phone numbers for WhatsApp.) Each student will need a free Google account to contribute to the paper, so if any member does not have one, now is the time to set that up. Throughout the term, your team will create the components of a research paper and presentation, which will both be submitted in their entirety in Week 7.

Paper:

The paper will be written collaboratively. Divide the work so team members contribute cross-functionally based upon work experience and/or field of study to analysis. Critically analyze the issues related to your topic within the context of the current healthcare environment, and also considering future directions in U.S. medical care. Web references, books, and professional journal articles should be considered as references. And don't overlook the DeVry Online Library as an important source of information for your paper!

Work collaboratively on the paper using Google Docs (https://www.google.com/docs/about/ (Links to an external site.)). One member of the team will upload a Word doc to Google Docs and invite the other team members and your instructor to share the document. As you do the research, contribute your findings to the shared document. Suggestion: pay particular attention to the accurate citation of research sources and be sure to cite sources as you go, or inserting them later will be extremely difficult and time consuming.

Each member of the team must download a copy of the Google Doc and save it in MS Word for submission to their own Dropbox in Weeks 2, 5 and 7 for grading. Each team member must also attach a copy of the paper to a Week 8 Course Project Peer Review Discussion post for grading.

Presentation:

The presentation should summarize the team's paper and be a collaborative effort. Pay particular attention to the accurate citation of the research sources- data, images, charts, graphs, etc. used on the slides.

Each member of the team must post a link to the presentation in the Week 7 Course Project Dropbox and in a Week 8 Course Project Peer Review Discussion post (see guidelines for Paper submission in Weeks 7 and 8 above) for grading.

Guidelines

Paper:

Your team's paper should be 7-10 pages in length (excluding cover and references pages), with 12-point Times font, double-spaced with one inch margins, running head, and page numbers - all in accordance with APA formatting. Include a cover page, table of contents, introduction, body of the report, summary/conclusion, and references page.

Even though this is not a scientific writing assignment, and is mostly creative in nature, references are still very important. At least six authoritative outside references are required. These should be listed on the last page, titled References.

Appropriate citations are required.

All DeVry University policies are in effect, including the plagiarism policy.

Papers are due during Week 7 of this course.

Any questions about this paper may be discussed in the weekly Q & A Discussion topic.

This Course Project Paper is worth 320 total points and will be graded on quality of research topic, quality of paper information, use of citations, grammar, and sentence structure.

Presentation

Your team's presentation should be eight slides in length (excluding introduction and references pages), with a light background, dark font, 3-5 bullet points per slide, and consistency among all slides. Include an introduction slide a references slide. Pay particular attention to the accurate citation of the research sources and images, charts, graphs, etc. used on the slides.

Appropriate citations are required.

All DeVry University policies are in effect, including the plagiarism policy.

Presentations are due during Week 7 of this course.

Any questions about this paper may be discussed in the weekly Q & A Discussion topic.

This presentation is worth 150 total points and will be graded on professionalism, clarity of summary, consistency among slides, and use of citations.

Possible Course Project Topics

Pros and Cons of Managed Care in America

Challenges in Managing Health Maintenance Organizations (HMOs)

Challenges in Managing Preferred Provider Organizations (PPOs)

Problems in Network Contracting for Managed Care

Legal Issues Associated With Managed Care Contracting

Challenges in Utilization and Case Management in Managed Care

Approaches to Disease Management in Managed Care

Managing Quality Improvement in Managed Care

Achieving Effective Marketing and Sales in Managed Care

Achieving and Maintaining Accreditation in Managed Care

Preventing Fraud and Abuse in Managed Care

Complying With State and Federal Regulation of Managed Care

Problems in Medicare Managed Care

Problems in Medicaid Managed Care

Effective Information Systems in Managed Care

Challenges in Patient Relations for Managed Care

Challenges in Provider Relations for Managed Care

NOTE: Other topics related to course content and COs are acceptable, but only as approved in advance by your professor.

Milestones

The Course Project is worth 370 points (50 for the Course Project topic, 100 for the Course Project outline, 170 for the final Course Project, and 50 for the Peer Review).

Topic (Week 2): 50 points

It is expected that you will provide a focused topic, including a statement of the key challenges or problems currently associated with the topic in America.

Outline (Week 5): 100 points

It is expected that the outline be submitted in a formal outline format as demonstrated below. Your outline should show enough detail to demonstrate that you have begun thinking about the organization of your paper and the research required into the topic. After your outline, please submit a listing of the sources you have already identified for your paper.

Each Roman numeral should be a main section of the paper.

Subpoint

Details of Subpoint

Details Related to the Subpoint

Subpoint

Final Paper (Week 7): 170 points

It is expected that the final version of your team's Paper will be 7-10 pages in length (excluding cover page, references page, and any appendices, with 6-8 sources identified. APA in-text citation is required in addition to listing all of your sources on a works cited page at the end of the document. Your grade will be affected if you do not cite or identify your sources correctly.

Presentation (Week 7): 150 points

It is expected that your team's presentation will be eight slides in length (excluding introduction and references slides). Your grade will be affected if you do not cite or identify your sources correctly on the slide on which they appear and in a summary references slide at the end of the presentation.

Peer Review (Week 8): 50 Points

After you have submitted your paper and presentation in Week 7, you will then attach your final paper and a link to your presentation to a discussion posting in Week 8. Please make sure to do this as early as possible. You will then find two other projects to review in the Week 8 Discussion and submit your critiques in a discussion post.

Sections of Your Project

Your final paper must include the following sections in addition to a cover page and table of contents. It may also include other sections if you deem it necessary and appropriate.

Introduction

Background

Define the Challenges and Problems Associated With Your Topic

Review of the Literature

Challenges/Problems Analysis

Recommend Solutions

Implementation of Solutions

Justification

Summary and Conclusion

Works Cited

Your presentation must summarize your paper in a professional manner that would be appropriate to present to a Board of Directors.

 

 

 

HSM420 Managed Care and Health Insurance

Week 5 Assignment  

Objectives

This HSM420 Course Project provides you with an opportunity to work in a team environment to select one important health insurance, managed care, or healthcare reform challenge (or problem to solve), analyze it in greater depth in a written format, and summarize it in a presentation.

Team Formation:

During Week 1, your instructor will divide the class into small groups of three or four students. Introduce yourselves and set up group messaging on WhatsApp or in the course shell. (You can initially email each other through the course shell to exchange phone numbers for WhatsApp.) Each student will need a free Google account to contribute to the paper, so if any member does not have one, now is the time to set that up. Throughout the term, your team will create the components of a research paper and presentation, which will both be submitted in their entirety in Week 7.

Paper:

The paper will be written collaboratively. Divide the work so team members contribute cross-functionally based upon work experience and/or field of study to analysis. Critically analyze the issues related to your topic within the context of the current healthcare environment, and also considering future directions in U.S. medical care. Web references, books, and professional journal articles should be considered as references. And don't overlook the DeVry Online Library as an important source of information for your paper!

Work collaboratively on the paper using Google Docs (https://www.google.com/docs/about/ (Links to an external site.)). One member of the team will upload a Word doc to Google Docs and invite the other team members and your instructor to share the document. As you do the research, contribute your findings to the shared document. Suggestion: pay particular attention to the accurate citation of research sources and be sure to cite sources as you go, or inserting them later will be extremely difficult and time consuming.

Each member of the team must download a copy of the Google Doc and save it in MS Word for submission to their own Dropbox in Weeks 2, 5 and 7 for grading. Each team member must also attach a copy of the paper to a Week 8 Course Project Peer Review Discussion post for grading.

Presentation:

The presentation should summarize the team's paper and be a collaborative effort. Pay particular attention to the accurate citation of the research sources- data, images, charts, graphs, etc. used on the slides.

Each member of the team must post a link to the presentation in the Week 7 Course Project Dropbox and in a Week 8 Course Project Peer Review Discussion post (see guidelines for Paper submission in Weeks 7 and 8 above) for grading.

Guidelines

Paper:

Your team's paper should be 7-10 pages in length (excluding cover and references pages), with 12-point Times font, double-spaced with one inch margins, running head, and page numbers - all in accordance with APA formatting. Include a cover page, table of contents, introduction, body of the report, summary/conclusion, and references page.

Even though this is not a scientific writing assignment, and is mostly creative in nature, references are still very important. At least six authoritative outside references are required. These should be listed on the last page, titled References.

Appropriate citations are required.

All DeVry University policies are in effect, including the plagiarism policy.

Papers are due during Week 7 of this course.

Any questions about this paper may be discussed in the weekly Q & A Discussion topic.

This Course Project Paper is worth 320 total points and will be graded on quality of research topic, quality of paper information, use of citations, grammar, and sentence structure.

Presentation

Your team's presentation should be eight slides in length (excluding introduction and references pages), with a light background, dark font, 3-5 bullet points per slide, and consistency among all slides. Include an introduction slide a references slide. Pay particular attention to the accurate citation of the research sources and images, charts, graphs, etc. used on the slides.

Appropriate citations are required.

All DeVry University policies are in effect, including the plagiarism policy.

Presentations are due during Week 7 of this course.

Any questions about this paper may be discussed in the weekly Q & A Discussion topic.

This presentation is worth 150 total points and will be graded on professionalism, clarity of summary, consistency among slides, and use of citations.

Possible Course Project Topics

Pros and Cons of Managed Care in America

Challenges in Managing Health Maintenance Organizations (HMOs)

Challenges in Managing Preferred Provider Organizations (PPOs)

Problems in Network Contracting for Managed Care

Legal Issues Associated With Managed Care Contracting

Challenges in Utilization and Case Management in Managed Care

Approaches to Disease Management in Managed Care

Managing Quality Improvement in Managed Care

Achieving Effective Marketing and Sales in Managed Care

Achieving and Maintaining Accreditation in Managed Care

Preventing Fraud and Abuse in Managed Care

Complying With State and Federal Regulation of Managed Care

Problems in Medicare Managed Care

Problems in Medicaid Managed Care

Effective Information Systems in Managed Care

Challenges in Patient Relations for Managed Care

Challenges in Provider Relations for Managed Care

NOTE: Other topics related to course content and COs are acceptable, but only as approved in advance by your professor.

Milestones

The Course Project is worth 370 points (50 for the Course Project topic, 100 for the Course Project outline, 170 for the final Course Project, and 50 for the Peer Review).

Topic (Week 2): 50 points

It is expected that you will provide a focused topic, including a statement of the key challenges or problems currently associated with the topic in America.

Outline (Week 5): 100 points

It is expected that the outline be submitted in a formal outline format as demonstrated below. Your outline should show enough detail to demonstrate that you have begun thinking about the organization of your paper and the research required into the topic. After your outline, please submit a listing of the sources you have already identified for your paper.

Each Roman numeral should be a main section of the paper.

Final Paper (Week 7): 170 points

It is expected that the final version of your team's Paper will be 7-10 pages in length (excluding cover page, references page, and any appendices, with 6-8 sources identified. APA in-text citation is required in addition to listing all of your sources on a works cited page at the end of the document. Your grade will be affected if you do not cite or identify your sources correctly.

Presentation (Week 7): 150 points

It is expected that your team's presentation will be eight slides in length (excluding introduction and references slides). Your grade will be affected if you do not cite or identify your sources correctly on the slide on which they appear and in a summary references slide at the end of the presentation.

Peer Review (Week 8): 50 Points

After you have submitted your paper and presentation in Week 7, you will then attach your final paper and a link to your presentation to a discussion posting in Week 8. Please make sure to do this as early as possible. You will then find two other projects to review in the Week 8 Discussion and submit your critiques in a discussion post.

Sections of Your Project

Your final paper must include the following sections in addition to a cover page and table of contents. It may also include other sections if you deem it necessary and appropriate.

Introduction

Background

Define the Challenges and Problems Associated With Your Topic

Review of the Literature

Challenges/Problems Analysis

Recommend Solutions

Implementation of Solutions

Justification

Summary and Conclusion

Works Cited

Your presentation must summarize your paper in a professional manner that would be appropriate to present to a Board of Directors.

 

HSM420 Managed Care and Health Insurance

Week 7 Assignment  

PAPER

This HSM420 Course Project provides you with an opportunity to work in a team environment to select one important health insurance, managed care, or healthcare reform challenge (or problem to solve), analyze it in greater depth in a written format, and summarize it in a presentation.

Team Formation:

During Week 1, your instructor will divide the class into small groups of three or four students. Introduce yourselves and set up group messaging on WhatsApp or in the course shell. (You can initially email each other through the course shell to exchange phone numbers for WhatsApp.) Each student will need a free Google account to contribute to the paper, so if any member does not have one, now is the time to set that up. Throughout the term, your team will create the components of a research paper and presentation, which will both be submitted in their entirety in Week 7.

Paper:

The paper will be written collaboratively. Divide the work so team members contribute cross-functionally based upon work experience and/or field of study to analysis. Critically analyze the issues related to your topic within the context of the current healthcare environment, and also considering future directions in U.S. medical care. Web references, books, and professional journal articles should be considered as references. And don't overlook the DeVry Online Library as an important source of information for your paper!

Work collaboratively on the paper using Google Docs (https://www.google.com/docs/about/ (Links to an external site.)). One member of the team will upload a Word doc to Google Docs and invite the other team members and your instructor to share the document. As you do the research, contribute your findings to the shared document. Suggestion: pay particular attention to the accurate citation of research sources and be sure to cite sources as you go, or inserting them later will be extremely difficult and time consuming.

Each member of the team must download a copy of the Google Doc and save it in MS Word for submission to their own Dropbox in Weeks 2, 5 and 7 for grading. Each team member must also attach a copy of the paper to a Week 8 Course Project Peer Review Discussion post for grading.

Presentation:

The presentation should summarize the team's paper and be a collaborative effort. Pay particular attention to the accurate citation of the research sources- data, images, charts, graphs, etc. used on the slides.

Each member of the team must post a link to the presentation in the Week 7 Course Project Dropbox and in a Week 8 Course Project Peer Review Discussion post (see guidelines for Paper submission in Weeks 7 and 8 above) for grading.

Guidelines

Paper:

Your team's paper should be 7-10 pages in length (excluding cover and references pages), with 12-point Times font, double-spaced with one inch margins, running head, and page numbers - all in accordance with APA formatting. Include a cover page, table of contents, introduction, body of the report, summary/conclusion, and references page.

Even though this is not a scientific writing assignment, and is mostly creative in nature, references are still very important. At least six authoritative outside references are required. These should be listed on the last page, titled References.

Appropriate citations are required.

All DeVry University policies are in effect, including the plagiarism policy.

Papers are due during Week 7 of this course.

Any questions about this paper may be discussed in the weekly Q & A Discussion topic.

This Course Project Paper is worth 320 total points and will be graded on quality of research topic, quality of paper information, use of citations, grammar, and sentence structure.

Presentation

Your team's presentation should be eight slides in length (excluding introduction and references pages), with a light background, dark font, 3-5 bullet points per slide, and consistency among all slides. Include an introduction slide a references slide. Pay particular attention to the accurate citation of the research sources and images, charts, graphs, etc. used on the slides.

Appropriate citations are required.

All DeVry University policies are in effect, including the plagiarism policy.

Presentations are due during Week 7 of this course.

Any questions about this paper may be discussed in the weekly Q & A Discussion topic.

This presentation is worth 150 total points and will be graded on professionalism, clarity of summary, consistency among slides, and use of citations.

Possible Course Project Topics

Pros and Cons of Managed Care in America

Challenges in Managing Health Maintenance Organizations (HMOs)

Challenges in Managing Preferred Provider Organizations (PPOs)

Problems in Network Contracting for Managed Care

Legal Issues Associated With Managed Care Contracting

Challenges in Utilization and Case Management in Managed Care

Approaches to Disease Management in Managed Care

Managing Quality Improvement in Managed Care

Achieving Effective Marketing and Sales in Managed Care

Achieving and Maintaining Accreditation in Managed Care

Preventing Fraud and Abuse in Managed Care

Complying With State and Federal Regulation of Managed Care

Problems in Medicare Managed Care

Problems in Medicaid Managed Care

Effective Information Systems in Managed Care

Challenges in Patient Relations for Managed Care

Challenges in Provider Relations for Managed Care

NOTE: Other topics related to course content and COs are acceptable, but only as approved in advance by your professor.

Milestones

The Course Project is worth 370 points (50 for the Course Project topic, 100 for the Course Project outline, 170 for the final Course Project, and 50 for the Peer Review).

Topic (Week 2): 50 points

It is expected that you will provide a focused topic, including a statement of the key challenges or problems currently associated with the topic in America.

Outline (Week 5): 100 points

It is expected that the outline be submitted in a formal outline format as demonstrated below. Your outline should show enough detail to demonstrate that you have begun thinking about the organization of your paper and the research required into the topic. After your outline, please submit a listing of the sources you have already identified for your paper.

Each Roman numeral should be a main section of the paper.

Final Paper (Week 7): 170 points

It is expected that the final version of your team's Paper will be 7-10 pages in length (excluding cover page, references page, and any appendices, with 6-8 sources identified. APA in-text citation is required in addition to listing all of your sources on a works cited page at the end of the document. Your grade will be affected if you do not cite or identify your sources correctly.

Presentation (Week 7): 150 points

It is expected that your team's presentation will be eight slides in length (excluding introduction and references slides). Your grade will be affected if you do not cite or identify your sources correctly on the slide on which they appear and in a summary references slide at the end of the presentation.

Peer Review (Week 8): 50 Points

After you have submitted your paper and presentation in Week 7, you will then attach your final paper and a link to your presentation to a discussion posting in Week 8. Please make sure to do this as early as possible. You will then find two other projects to review in the Week 8 Discussion and submit your critiques in a discussion post.

Sections of Your Project

Your final paper must include the following sections in addition to a cover page and table of contents. It may also include other sections if you deem it necessary and appropriate.

Introduction

Background

Define the Challenges and Problems Associated With Your Topic

Review of the Literature

Challenges/Problems Analysis

Recommend Solutions

Implementation of Solutions

Justification

Summary and Conclusion

Works Cited

Your presentation must summarize your paper in a professional manner that would be appropriate to present to a Board of Directors.

 

HSM420 Managed Care and Health Insurance

Week 7 Assignment  

Presentation

This HSM420 Course Project provides you with an opportunity to work in a team environment to select one important health insurance, managed care, or healthcare reform challenge (or problem to solve), analyze it in greater depth in a written format, and summarize it in a presentation.

Team Formation:

During Week 1, your instructor will divide the class into small groups of three or four students. Introduce yourselves and set up group messaging on WhatsApp or in the course shell. (You can initially email each other through the course shell to exchange phone numbers for WhatsApp.) Each student will need a free Google account to contribute to the paper, so if any member does not have one, now is the time to set that up. Throughout the term, your team will create the components of a research paper and presentation, which will both be submitted in their entirety in Week 7.

Paper:

The paper will be written collaboratively. Divide the work so team members contribute cross-functionally based upon work experience and/or field of study to analysis. Critically analyze the issues related to your topic within the context of the current healthcare environment, and also considering future directions in U.S. medical care. Web references, books, and professional journal articles should be considered as references. And don't overlook the DeVry Online Library as an important source of information for your paper!

Work collaboratively on the paper using Google Docs (https://www.google.com/docs/about/ (Links to an external site.)). One member of the team will upload a Word doc to Google Docs and invite the other team members and your instructor to share the document. As you do the research, contribute your findings to the shared document. Suggestion: pay particular attention to the accurate citation of research sources and be sure to cite sources as you go, or inserting them later will be extremely difficult and time consuming.

Each member of the team must download a copy of the Google Doc and save it in MS Word for submission to their own Dropbox in Weeks 2, 5 and 7 for grading. Each team member must also attach a copy of the paper to a Week 8 Course Project Peer Review Discussion post for grading.

Presentation:

The presentation should summarize the team's paper and be a collaborative effort. Pay particular attention to the accurate citation of the research sources- data, images, charts, graphs, etc. used on the slides.

Each member of the team must post a link to the presentation in the Week 7 Course Project Dropbox and in a Week 8 Course Project Peer Review Discussion post (see guidelines for Paper submission in Weeks 7 and 8 above) for grading.

Guidelines

Paper:

Your team's paper should be 7-10 pages in length (excluding cover and references pages), with 12-point Times font, double-spaced with one inch margins, running head, and page numbers - all in accordance with APA formatting. Include a cover page, table of contents, introduction, body of the report, summary/conclusion, and references page.

Even though this is not a scientific writing assignment, and is mostly creative in nature, references are still very important. At least six authoritative outside references are required. These should be listed on the last page, titled References.

Appropriate citations are required.

All DeVry University policies are in effect, including the plagiarism policy.

Papers are due during Week 7 of this course.

Any questions about this paper may be discussed in the weekly Q & A Discussion topic.

This Course Project Paper is worth 320 total points and will be graded on quality of research topic, quality of paper information, use of citations, grammar, and sentence structure.

Presentation

Your team's presentation should be eight slides in length (excluding introduction and references pages), with a light background, dark font, 3-5 bullet points per slide, and consistency among all slides. Include an introduction slide a references slide. Pay particular attention to the accurate citation of the research sources and images, charts, graphs, etc. used on the slides.

Appropriate citations are required.

All DeVry University policies are in effect, including the plagiarism policy.

Presentations are due during Week 7 of this course.

Any questions about this paper may be discussed in the weekly Q & A Discussion topic.

This presentation is worth 150 total points and will be graded on professionalism, clarity of summary, consistency among slides, and use of citations.

Possible Course Project Topics

Pros and Cons of Managed Care in America

Challenges in Managing Health Maintenance Organizations (HMOs)

Challenges in Managing Preferred Provider Organizations (PPOs)

Problems in Network Contracting for Managed Care

Legal Issues Associated With Managed Care Contracting

Challenges in Utilization and Case Management in Managed Care

Approaches to Disease Management in Managed Care

Managing Quality Improvement in Managed Care

Achieving Effective Marketing and Sales in Managed Care

Achieving and Maintaining Accreditation in Managed Care

Preventing Fraud and Abuse in Managed Care

Complying With State and Federal Regulation of Managed Care

Problems in Medicare Managed Care

Problems in Medicaid Managed Care

Effective Information Systems in Managed Care

Challenges in Patient Relations for Managed Care

Challenges in Provider Relations for Managed Care

NOTE: Other topics related to course content and COs are acceptable, but only as approved in advance by your professor.

Milestones

The Course Project is worth 370 points (50 for the Course Project topic, 100 for the Course Project outline, 170 for the final Course Project, and 50 for the Peer Review).

Topic (Week 2): 50 points

It is expected that you will provide a focused topic, including a statement of the key challenges or problems currently associated with the topic in America.

Outline (Week 5): 100 points

It is expected that the outline be submitted in a formal outline format as demonstrated below. Your outline should show enough detail to demonstrate that you have begun thinking about the organization of your paper and the research required into the topic. After your outline, please submit a listing of the sources you have already identified for your paper.

Each Roman numeral should be a main section of the paper.

Final Paper (Week 7): 170 points

It is expected that the final version of your team's Paper will be 7-10 pages in length (excluding cover page, references page, and any appendices, with 6-8 sources identified. APA in-text citation is required in addition to listing all of your sources on a works cited page at the end of the document. Your grade will be affected if you do not cite or identify your sources correctly.

Presentation (Week 7): 150 points

It is expected that your team's presentation will be eight slides in length (excluding introduction and references slides). Your grade will be affected if you do not cite or identify your sources correctly on the slide on which they appear and in a summary references slide at the end of the presentation.

Peer Review (Week 8): 50 Points

After you have submitted your paper and presentation in Week 7, you will then attach your final paper and a link to your presentation to a discussion posting in Week 8. Please make sure to do this as early as possible. You will then find two other projects to review in the Week 8 Discussion and submit your critiques in a discussion post.

Sections of Your Project

Your final paper must include the following sections in addition to a cover page and table of contents. It may also include other sections if you deem it necessary and appropriate.

Introduction

Background

Define the Challenges and Problems Associated With Your Topic

Review of the Literature

Challenges/Problems Analysis

Recommend Solutions

Implementation of Solutions

Justification

Summary and Conclusion

Works Cited

Your presentation must summarize your paper in a professional manner that would be appropriate to present to a Board of Directors.

 

HSM420 Managed Care and Health Insurance

Week 8 Assignment  

Objectives

This HSM420 Course Project provides you with an opportunity to work in a team environment to select one important health insurance, managed care, or healthcare reform challenge (or problem to solve), analyze it in greater depth in a written format, and summarize it in a presentation.

Team Formation:

During Week 1, your instructor will divide the class into small groups of three or four students. Introduce yourselves and set up group messaging on WhatsApp or in the course shell. (You can initially email each other through the course shell to exchange phone numbers for WhatsApp.) Each student will need a free Google account to contribute to the paper, so if any member does not have one, now is the time to set that up. Throughout the term, your team will create the components of a research paper and presentation, which will both be submitted in their entirety in Week 7.

Paper:

The paper will be written collaboratively. Divide the work so team members contribute cross-functionally based upon work experience and/or field of study to analysis. Critically analyze the issues related to your topic within the context of the current healthcare environment, and also considering future directions in U.S. medical care. Web references, books, and professional journal articles should be considered as references. And don't overlook the DeVry Online Library as an important source of information for your paper!

Work collaboratively on the paper using Google Docs (https://www.google.com/docs/about/ (Links to an external site.)). One member of the team will upload a Word doc to Google Docs and invite the other team members and your instructor to share the document. As you do the research, contribute your findings to the shared document. Suggestion: pay particular attention to the accurate citation of research sources and be sure to cite sources as you go, or inserting them later will be extremely difficult and time consuming.

Each member of the team must download a copy of the Google Doc and save it in MS Word for submission to their own Dropbox in Weeks 2, 5 and 7 for grading. Each team member must also attach a copy of the paper to a Week 8 Course Project Peer Review Discussion post for grading.

Presentation:

The presentation should summarize the team's paper and be a collaborative effort. Pay particular attention to the accurate citation of the research sources- data, images, charts, graphs, etc. used on the slides.

Each member of the team must post a link to the presentation in the Week 7 Course Project Dropbox and in a Week 8 Course Project Peer Review Discussion post (see guidelines for Paper submission in Weeks 7 and 8 above) for grading.

Guidelines

Paper:

Your team's paper should be 7-10 pages in length (excluding cover and references pages), with 12-point Times font, double-spaced with one inch margins, running head, and page numbers - all in accordance with APA formatting. Include a cover page, table of contents, introduction, body of the report, summary/conclusion, and references page.

Even though this is not a scientific writing assignment, and is mostly creative in nature, references are still very important. At least six authoritative outside references are required. These should be listed on the last page, titled References.

Appropriate citations are required.

All DeVry University policies are in effect, including the plagiarism policy.

Papers are due during Week 7 of this course.

Any questions about this paper may be discussed in the weekly Q & A Discussion topic.

This Course Project Paper is worth 320 total points and will be graded on quality of research topic, quality of paper information, use of citations, grammar, and sentence structure.

Presentation

Your team's presentation should be eight slides in length (excluding introduction and references pages), with a light background, dark font, 3-5 bullet points per slide, and consistency among all slides. Include an introduction slide a references slide. Pay particular attention to the accurate citation of the research sources and images, charts, graphs, etc. used on the slides.

Appropriate citations are required.

All DeVry University policies are in effect, including the plagiarism policy.

Presentations are due during Week 7 of this course.

Any questions about this paper may be discussed in the weekly Q & A Discussion topic.

This presentation is worth 150 total points and will be graded on professionalism, clarity of summary, consistency among slides, and use of citations.

Possible Course Project Topics

Pros and Cons of Managed Care in America

Challenges in Managing Health Maintenance Organizations (HMOs)

Challenges in Managing Preferred Provider Organizations (PPOs)

Problems in Network Contracting for Managed Care

Legal Issues Associated With Managed Care Contracting

Challenges in Utilization and Case Management in Managed Care

Approaches to Disease Management in Managed Care

Managing Quality Improvement in Managed Care

Achieving Effective Marketing and Sales in Managed Care

Achieving and Maintaining Accreditation in Managed Care

Preventing Fraud and Abuse in Managed Care

Complying With State and Federal Regulation of Managed Care

Problems in Medicare Managed Care

Problems in Medicaid Managed Care

Effective Information Systems in Managed Care

Challenges in Patient Relations for Managed Care

Challenges in Provider Relations for Managed Care

NOTE: Other topics related to course content and COs are acceptable, but only as approved in advance by your professor.

Milestones

The Course Project is worth 370 points (50 for the Course Project topic, 100 for the Course Project outline, 170 for the final Course Project, and 50 for the Peer Review).

Topic (Week 2): 50 points

It is expected that you will provide a focused topic, including a statement of the key challenges or problems currently associated with the topic in America.

Outline (Week 5): 100 points

It is expected that the outline be submitted in a formal outline format as demonstrated below. Your outline should show enough detail to demonstrate that you have begun thinking about the organization of your paper and the research required into the topic. After your outline, please submit a listing of the sources you have already identified for your paper.

Final Paper (Week 7): 170 points

It is expected that the final version of your team's Paper will be 7-10 pages in length (excluding cover page, references page, and any appendices, with 6-8 sources identified. APA in-text citation is required in addition to listing all of your sources on a works cited page at the end of the document. Your grade will be affected if you do not cite or identify your sources correctly.

Presentation (Week 7): 150 points

It is expected that your team's presentation will be eight slides in length (excluding introduction and references slides). Your grade will be affected if you do not cite or identify your sources correctly on the slide on which they appear and in a summary references slide at the end of the presentation.

Peer Review (Week 8): 50 Points

After you have submitted your paper and presentation in Week 7, you will then attach your final paper and a link to your presentation to a discussion posting in Week 8. Please make sure to do this as early as possible. You will then find two other projects to review in the Week 8 Discussion and submit your critiques in a discussion post.

Sections of Your Project

Your final paper must include the following sections in addition to a cover page and table of contents. It may also include other sections if you deem it necessary and appropriate.

Introduction

Background

Define the Challenges and Problems Associated With Your Topic

Review of the Literature

Challenges/Problems Analysis

Recommend Solutions

Implementation of Solutions

Justification

Summary and Conclusion

Works Cited

Your presentation must summarize your paper in a professional manner that would be appropriate to present to a Board of Directors.