LP6 Assignment: Employer RFP
The assignment assesses competency 4. Examine the principles, structure, and operation of health insurance programs in relationship to managed care organizations, 13. Critique the managed care concept in the workplace.
The paper should be 6 to 12 pages in length.
SCENARIO: You are responsible for the request for proposal (RFP) department in an MCO. Several employers have come to you looking for health insurance benefit offerings to its employees. You are to provide a package of health care insurance benefit coverage recommendations based on the size of each company: small group, medium group, and large group.
- For each company size, recommend the services you would offer that sized company. Include how those services would be organized. You may assume anything you want about the employer. Incorporate your assumptions into your paper.
- Be sure to include such things as what payment systems would be implemented (fee-for-service? capitation? deduction? and so forth).
- How would you incorporate inpatient and outpatient services? How would you handle behavioral health services?
- For each company size, your paper should be about 2 to 4 pages in length. Double space and use 1 inch margins all around in 12 point Times New Roman font.
- Use headers freely to help outline your various recommendations for structure and content
- There is no one correct answer to this. Your task is to demonstrate through this assignment that you understand the structure, internal operations of MCOs and health care options as presented in the text.
- When writing, consider these questions:
- What might a small/medium/large group employer look like?
- What sort of financial structure would you recommend?
- What would be the physician relations and so forth?
- Use the text as a guide as to other factors that should be included in your paper. Details are good here.
- Consider the reader in how you structure each of your employer recommendations. Do not write paragraphs that are 50 lines long. Break up your content into paragraphs that reflect changes in topic or thought. As stated above, use headers freely. Proper grammar is important. Proof read your assignment for spelling and grammar before you submit it.
|1.||Paper address each employer group: small, medium and large.|
|2.||Paper addresses payment systems.|
|3.||Paper addresses inpatient services.|
|4.||Paper addresses outpatient services.|
|5.||Paper addresses mental health services.|
|6.||Paper considers financial structure.|
|7.||Paper cites references if/when appropriate.|
|8.||Paper includes 2 to 4 pages per plan for each employer group size.|
|9.||Paper exhibits correct and appropriate grammar, punctuation, spelling, syntax, and word usage.|
|10.||Paper is on time.|