Running head: IMPACT OF AMA ON HEALTH CARE REFORM
Module 1 Critical Thinking: Impact of AMA on Health Care Reform
Colorado State University Global Campus
HCM400 Managed Care and Health Insurance
Dr. Danita Hunter
January 9, 2015
IMPACT OF AMA ON HEALTH
Discuss one of the key ways that a typical board can lower an organizations risk profile. Consider the
following questions as you post your initial response:
Which function of the board is related to risk management?
What are the obligations of the board?
What is the value of disease prevention? Provide an example of a disease prevention program (either
within the U.S. or international). Include a discussion of how a health plan would accomplish the
Implement a prevention program
The Colorado Division of Insurance (DOI) is a division within the Colorado Department of
Regulatory Agencies (DORA) This division of DORA regulates and monitor the insurance
industry to ensure everyone is following the regulations set forth by law. The DO
Staffing ratios for the claims capability depend on the
number needed to meet volume demands while
maintaining quality standards and not relying on
overtime hours as a permanent solution.
State and federal regulations consistently apply
Hospital consolidation has been blocked more often
37. than not by the Department of Justice (DOJ) and/or
the Federal Trade Commission (FTC).
Hospitals purchased physician practices and employed
physicians in the 1990s, but will no longe
18. Costs of noncatastrophic, recurring outpatient care have risen significantly in the past few
19. Data used by health plans to pay claims can be used for analytic purposes.
20. The defining feature of a direct contract model is the
1. Academic detailing refers to:
Personal meetings between a respected clinician and a doctor or a small group of doctors
2. Administrative claims data cannot be used to calculate quality measures.
3. Advantages of an IPA include:
All of these.
Running head: PREVENTION OF ILLNESS
Option 1: Prevention of Illness
Managed Care and Health Insurance
PREVENTION OF ILLNESS
Prevention is such a broad term that can be used numerous ways. When discussing
prevention of illness, its important to clearly
Identify a situation that may make it difficult for health plans to develop and maintain a network.
Choose one approach that a health plan might take to overcome this challenge and consider the
following questions as you respond:
Why do you feel your sele