Institutional Ethics, Define and propose what structure your MCO/HMO will use to maximize the ethical delivery of health care to your patients

Your health care organization has decided to undergo a major restructuring to better align with the new Patient Protection and Affordable Care Act (PPACA) of 2010. You have been tasked with developing a managed care organization (MCO) and health maintenance organization (HMO) that will have as its core mission the ethical treatment of patients in their health care needs. Discuss the following in a double-spaced paper of 3–4 pages:

  • Define and propose what structure your MCO/HMO will use to maximize the ethical delivery of health care to your patients.
  • Research the library and other resources detailing best practices in MCO/HMO structuring to defend your answer

Deliverable Length: 3–4 pages

Expert Solution Preview

Introduction:
The Patient Protection and Affordable Care Act (PPACA) of 2010 has brought significant changes to the healthcare industry in the United States. With the aim of promoting ethical treatment of patients, this paper will propose a structure for a Managed Care Organization (MCO) and Health Maintenance Organization (HMO).

Define and propose what structure your MCO/HMO will use to maximize the ethical delivery of healthcare to your patients:
The proposed structure for the MCO/HMO will involve the integration of various healthcare providers and facilities under one umbrella organization. This will create a network of healthcare providers who will work together to ensure that patients receive quality and ethical care. The structure will be designed to align with the PPACA and will uphold the following principles:

1. Patient-Centered Care: The MCO/HMO will prioritize the needs and preferences of patients in the delivery of healthcare services. The organization will provide options for patients to choose the healthcare provider that best suits their needs.

2. Coordinated Care: The MCO/HMO will ensure that healthcare providers work together to provide comprehensive care to patients. The organization will create a system that tracks patients’ medical records and care plans to ensure that all healthcare providers are informed and coordinated in their efforts.

3. Quality Care: The MCO/HMO will promote standardized care guidelines and provide training to healthcare providers to ensure that patients receive quality care that upholds ethical standards. The organization will conduct regular audits to monitor the quality of care provided.

Research the library and other resources detailing best practices in MCO/HMO structuring to defend your answer:
Studies have shown that a coordinated and integrated approach to healthcare delivery improves patient outcomes and reduces healthcare costs. According to a report by the National Institutes of Health (NIH), integrated healthcare systems promote patient-centered care and improve outcomes by providing comprehensive care and reducing redundancies. This is achieved through the creation of networks that allow primary care providers to collaborate with specialists and other healthcare providers.

Furthermore, a study by the American Medical Association (AMA) found that coordinated care reduces the number of unnecessary tests and procedures that can lead to higher healthcare costs. The study also showed that managed care organizations promote ethical care by providing quality care guidelines and monitoring the quality of care provided.

Conclusion:
In conclusion, a managed care organization and health maintenance organization that prioritize patient-centered care, coordinated care, and quality care can maximize the ethical delivery of healthcare services to patients. By integrating healthcare providers and facilities under one umbrella organization, the MCO/HMO can ensure that patients receive comprehensive and standardized care that upholds ethical standards.

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