1.Describe the role of th HMO Act of 1973 in promoting the growth of managed care in the United States. Why was this important ? 2.Briefly decribe the term “managed care”? 3.Briefly explain how the HMO Act of 1973 contributed to teh grouwth of managed care 4.Explain the primary differences between managed are programs and the traditional “fee-for-service” model of healthcare. How is payment mehtodology differnet in the two approaches?5. What is “capitation”? Why do managed care organization like to utilize capitation for ? 6.Briefly describe the process of managing utilization of acute and chronic care within MCO program. 7.How would you drcribe an integrated care system? What does it look like in practice? 8.In managed care terminaology , what is ment by a “specialtly phisicans” ? How are these physicians handled differntly than other doctors in managed care? 9.Describe the key elements in most capitation programs for primary care service 10.Decribe the key steps in th edevelopment of a total quality management program for an MCO. WHy would MCOs want to implement such a program? 11.The practice of healthcare utilization management involves 3 types of activites performed at different times in the patients care. WHat are these types of activities? 12.Explain th erole of the primary care physician in managed care relative to specialty physican services, diagonostics and therapeutics.
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