Course Description:
This course examines the evolution and future of managed care in the United States while examining the service delivery systems and business components that comprise the various models of managed care. We will consider the challenges and factors that affect the quality of care and the impact on stakeholders. There will be an opportunity to compare managed care organizations to determine quality and impact on consumer decisions and public health processes. Students will be challenged to look beyond their perceptions and frustrations to examine the complexities that comprise the ongoing development and implementation of managed care to include the functions of: utilization review; regulatory and accreditation compliance; service delivery to vulnerable populations; financing mechanisms and fiscal accountability; information technology; and community outreach and marketing.
Prerequisite: Introduction to Human Services or United States Health Systems or equivalent.
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