Foundations of Managed Care Due Thursday 12/18/2014

Medicaid managed care serves a population with complex needs. List and explain two operational challenges faced by Medicaid managed care.

 

Members contact their health plans for a variety of reasons. List two of these reasons.

 

Administrative claims data can serve many different uses for reporting and analysis in managed care. List two potential use.

 

List two examples of tools that a health plan can use to promote disease prevention among its members.

 

List two advantages and two disadvantages for a health plan using a PBM to manage its pharmacy services rather than developing or building these services internally