Imam Abdulrahman Bin Faisal University Visual Studio Step by Step Lab Report HS171: Managed Care Group Paper Topics Group 1 2 3 4 5 6 7 8 9 10 11 Topic Do

Imam Abdulrahman Bin Faisal University Visual Studio Step by Step Lab Report HS171: Managed Care
Group Paper Topics
Group
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11
Topic
Do MCOs authorize psychotherapy? Why or
why not?
Which MCO patients are considered high
utilizers? How do MCOs manage high utilizers?
Suggested Starting Reference
http://www.nytimes.com/2011/03/06/health/policy/06doctors.htm
l?_r=1&scp=1&sq=psychiatrist%20talk%20therapy&st=cse
https://www.managedcaremag.com/archives/2014/1/high-utilizingpatients-where-are-savings
Which entities lobby on behalf of MCOs?
Why did Connecticut, the “insurance capital of
the world,” abandon Managed Medicaid in
2012?
Do members of Congress get health care from
MCOs?
Which states regulate health insurance
premiums or cost sharing?
In 2014, the California Department of Managed
Health Care Issued a $4 million fine to Kaiser?
Why?
In Iowa, Managed Medicaid insurers claim they
are losing money. Why do these insurers keep
their Managed Medicaid contracts?
https://www.ahip.org/
http://usatoday30.usatoday.com/news/nation/story/2011-1228/connecticut-health-care-medicare-insurance/52257962/1
How much did health insurance cost sharing
increase over the past 10 years? Why?
Are HMO so-called horror stories true? Cite
examples and critiques of horror stories.
Who are the “big 5” health insurance
companies? How much do they earn? How
much influence do they wield?
http://www.healthsystemtracker.org/insight/payments-for-costsharing-increasing-rapidly-over-time/
http://californiahealthline.org/morning-breakout/hmo-horrorstories-sometimes-facts-are-onesided-endstoryhed/
https://www.verywell.com/the-big-five-health-insurance-companies2663838
For years, it has been alleged that Sutter
overcharges hospital services due to market
concentration. Were are are these claims true?
Having health insurance might mean: no
mental health care access. Does managed care
limit access to mental health care?
Have Medicare Advantage plans overcharged
the federal government?
Please profile the life and health policy of
Wendell Potter and his deconstruction of the
health insurance industry’s public relations
campaign on “choice.”
http://www.latimes.com/business/la-fi-blue-shield-sutter-20150106story.html
http://www.latimes.com/business/la-fi-laz-congress-membershealth-insurance-20150218-story.html
http://www.ncsl.org/research/health/health-insurance-rateapproval-disapproval.aspx
http://californiahealthline.org/morning-breakout/kaiser-to-pay-4mfine-over-violations-of-calif-mental-health-laws/
http://www.desmoinesregister.com/story/news/health/2016/11/30
/medicaid-management-firms-continue-lose-millions/94677564/
12
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15
https://www.nbcnews.com/think/opinion/having-health-insurancedoesn-t-mean-mental-health-care-access-ncna1026181
https://khn.org/news/medicare-advantage-overbills-taxpayers-bybillions-a-year-as-feds-struggle-to-stop-it/
https://www.nytimes.com/2020/01/14/opinion/healthcare-choicedemocratic-debate.html?searchResultPosition=1
GUIDELINES FOR THE PAPER
Format of Research Paper: 5-7 pages
1. Introduction: 1-2 pages
2. Analysis: Explore your assigned topic and how it relates to issues we have discussed in class
this semeter. 2-3 pages
3. Discussion: 2 pages
4. References: no limit.
Guidelines
Introduction: State your assigned topic. Provide a brief introduction of the topic and its
relevance to managed care or managed care organizations.
Analysis: Please address all of the following elements, not necessarily in this order:
• Explore the assigned topic in detail. Build an argument/analysis using specific references
that are sourced.
• Make explicit reference to managed care and/or managed care organizations, and the
principles that guide them, based on what you’ve learned in the course.
• Explore sources of information in addition to the “suggested starting reference” provided
along with your assigned topic.
Discussion: Overall evaluation and interpretation of the ideas presented in your paper.
Grading Criteria (75 points):
1. Introduction [15 points]
2. Analysis, including the use of sources to support specific claims. [35 points]
3. Discussion and Summary/Conclusion. [15 points]
4. Grammar, spelling, subtitles, APA format, and other format considerations [10 points]

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