Research and explain the purpose and importance of the managed care organization or nongovernmental agency,
Managed care was created to evolve a problem that was created by a solution to another problem. Health insurance exists fundamentally to reduce individual’s financial risks, as well as to organize and manage cost, utilization, and quality. Policy makers were faced with the decision to either regulate the health care industry and improve its efficiency or use competition to control costs. Republicans and President Nixon resisted regulation and instead introduced prepaid group practices as an option for controlling cost and utilization. Presidents Nixon’s advisors demonstrated that prepaid group practices offered compared health care at 15-20% lower costs with the reduction of hospital admissions and increase use of ambulatory care. (Yesalis, 2013) Dr. Paul Elwood came up with the term health maintenance organization also known as HMO. The first example of a HMO was in 1910 in Tacoma, Washington it was offered exclusively through its own providers with a broad range of medical services. (P.D Fox, 2007)
explain the importance of maintaining such information
It is crucial that health information should be well maintained and managed effectively. Information should be stored and protected for improving healthcare. With the current trend in the information technology, there has been a change to Electronic Health Records, thereby improving communication in the health sector, are replacing the manual records. This Electric Health information technology has transformed the healthcare service in the management of information and improved communication (Demian, & Walters, 2014).
Wellness and Health Promotion (WHP)
Wellness and Health Promotion (WHP) is an assessment accreditation that reviews on key areas of promoting health. developments and healthy choices.
Explain the benefit of wellness and health promotion standards in an organization.
The benefit of wellness and health promotion standards in an organization helps to improve work performances.
Define and provide the standards that are needed to meet the accreditation level for your organization. heading two
The benefits of Credentialing
The benefits of requiring credentialing/re-credentialing are that prior to being able to practice medicine. Physicians are required under law to keep up on their credentials no matter what their position is. If they are in charge of patient care they are required to uphold their licensures. According to the Joint Commission practitioners are required to renew their credentials every two years for long-term care. They also require that they submit any problems with their license such as disciplinary actions against it. It is the medical center where the practitioner wants to practice to follow through with checking his or her medical backgrounds such as training and licensures. (The Joint Commission, 2013)
Three standards of the accreditation level of credentialing
There are many standards and guidelines that need to be meet under the National Committee of Quality Assurance. I found three that I think are important for practitioners to follow.
Do practitioners applications to the organization include a current and signed attestation about why they cannot perform certain tasks; a history of loss of medical license and felony convictions; a history of limitation of privileges or disciplinary actions; and current malpractice insurance coverage?” (National Committee for Quality Assurance)
That the organizations has gathered all pertinent paperwork and documents that clearly state the practitioners qualifications (National Committee for Quality Assurance)
And that there be ongoing monitoring of the practitioner basically as a security measure that there aren’t any complaints and that they are doing their job. (National Committee for Quality Assurance)
Research and explain the purpose and importance of the managed care organization or nongovernmental agency, and explain the importance of maintaining such information. Heading number