C439 Healthcare Management Capstone – C439 2022

C439 Healthcare Management Capstone – C439 Task 1 A. Prepare a report (suggested length of 8–12 pages) in which you do the following: 1. Identify one of the following healthcare management opportunities you encountered in one of the previous performance assessments completed in this program: I have chosen to revisit the scenario wherein I am the CFO with Seamus Company, ushering in a change of health insurance plans from the performance assessment for Financial Resource Management in Healthcare (C428). 2. Identify one of the following professional lenses: I have chosen to view the scenario through the Manager lens. 3. Summarize the opportunity selected in part A1 from the perspective of the professional lens selected in part A2. Choosing a fiscally sustainable method in moving away from a fee-for-service model to a Managed Care Organization can be difficult. A manager must weigh the options presented and Task 1 - Atkinson Page 2 choose a method that is beneficial to both Seamus company and the employees. Healthcare costs have climbed higher in recent years with the fee-for-service model and managed care organizations do a great job of combatting those rising costs for the company by shifting those costs to the employees. 4. Provide a process overview by doing the following: a. Describe the process as it is being performed today. Currently, Seamus Company has a fee-for-service insurance plan for their employees. This plan will only pay the medical provider or the patient after the service is performed, when the patient files a claim. So, when the patient makes a visit, has a test, or a procedure done, they submit their claim; then, Seamus Company must provide some coverage of the overall cost. i. Describe the operational environment. Since Seamus Company is non-profit, its operational environment includes its employees, the community, beneficiaries, and even other non-profit companies that could benefit from a partnership. The environment has shifted in healthcare to become more and more expensive, affecting all these groups. Because of the rise in costs, Seamus Company is forced to investigate other avenues to save money. ii. Outline the sequence of events of the process. Task 1 - Atkinson