Introduction
In this paper, I will present my reflections on the module assignments to identify the areas that I excelled in and those that I need to improve on. In particular, the paper will focus on the knowledge and skills that I have acquired through the course. It will highlight the topics that I did not understand, the work that I did for the class, and the methods of measuring my future progress. Finally, the paper will provide a brief discussion on managed care organizations (MCO) and accountable care organizations (ACO).
Knowledge, Skills, and Abilities
I have been able to improve my knowledge, skills, and abilities in various ways. These include participating in all interactive learning sessions such as group discussions, completing module assignments, and personal reading. The modules presented during the course enabled me to acquire knowledge on various aspects of the U.S.A’s healthcare system such as the characteristics of various healthcare insurance offered in the country. Moreover, focusing on personal reading enabled me to gain a deeper understanding of the concepts and theories taught in class. Similarly, participating in interactive learning sessions enabled me to enrich my understanding by listening to other students’ opinions and to share my views with others. Consequently, my ability to apply the knowledge and skills that I have acquired through the course has significantly improved.
My success in acquiring improved knowledge, skills, and abilities can be demonstrated by the work I did for the class during the learning session. I was able to complete all my tasks and assignments in time, as well as, to work with other students to complete group work effectively. However, I could have performed better by supplementing the course content with external learning materials to improve my understanding of various concepts. Furthermore, I could have improved my performance by allocating more time for personal study, research, and completing various assignments.
Generally, I was able to understand all the topics taught during the course. However, I encountered challenges in understanding some topics such as the formation of ACOs and the implementation of PCMH. In this regard, the course materials for these topics should be improved through the provision of practical examples and case studies to enhance students’ understanding.
Measuring the effects of what I have learned will enable me to keep track of my future progress. Thus, I intend to use practice and skill checks to measure the effect of the knowledge I have acquired on my future progress. This will involve assessing the extent to which I can apply the knowledge and skills in my profession in the future. Additionally, I will measure the effect by examining the extent to which I will be able to remember and to share the taught concepts with others in the future. I expect the knowledge and skills to bolster my future progress because I have achieved all the course outcomes.
Managed Care Organizations (MCO)
Managed care was introduced in the United States as a form of health insurance that would reduce the cost of accessing healthcare in the country. Despite its potential to reduce the cost of healthcare, managed care has three drawbacks. First, it lacks flexibility in the choice of healthcare providers (Simonet, 2005, pp. 424-440). This is because the policyholders are allowed to access healthcare from participating providers only. Second, managed care is characterized by strict procedures, which lead to delays in access to healthcare (Simonet, 2005, pp. 424-440). As a result, patients’ health conditions usually worsen as they wait for an opportunity to access healthcare services. Third, managed care has led to the provision of low-quality healthcare as providers focus on saving costs rather than improving the quality of their services (Simonet, 2005, pp. 424-440).
Managed care differs from consumer-driven healthcare plans in terms of the provided benefits, cost-sharing, and ability to choose providers. In particular, a managed care plan (PPO) does not allow policyholders to access healthcare from their preferred providers. By contrast, a consumer-driven healthcare plan (HSA) allows its policyholders to access healthcare from providers of their choice (Hurley, Strunk, & White, 2004, pp. 56-68). Unlike the PPO plan, members of the HSA plan can access very complex medical procedures (Robinson & Ginsburg, 2009, pp. 272-281).
Accountable Care Organizations (ACOs)
ACOs consist of providers who share the responsibility of coordinating and delivering high-quality healthcare at low costs to a particular population. The services provided by the ACOs are paid for through the bundle system (CMS, 2013). Each bundle entitles the patient to specific healthcare services. Moreover, the patient cannot be barred from accessing the services provided under the bundle that he or she has chosen (Lazerow, 2013).
The bundle payment system has the advantage of enabling providers to reduce their charges without compromising their earnings (Lazerow, 2013). Overall, the ACO plan facilitates the provision of improved healthcare by rewarding providers for reducing incidences of readmission. Moreover, it promotes the use of evidence-based treatment methods to improve health outcomes.
References
CMS. (2013).Bundled payment for care improvement (BPCI) initiative: General information. Web.
Hurley, E., Strunk, C., & White, S. (2004). The puzzling popularity of the PPO. Health Affairs, 23(2), 56-68.
Lazerow, R. (2013). Bundled payment a stepping-stone for ACOs? I do not but it. Web.
Robinson, C., & Ginsburg, B. (2009). Consumer-driven health care: promise and performance. Health Affairs, 28(2), 272-281.
Simonet, D. (2005). Patient satisfaction under managed care. International Journal of Health Care Quality Assurance, 18(6), 424-440.