Basic Utilization and Case Management

Choose one option

Option #1: Managing Ancillary Utilization

Kongstvedt (2013) notes that the management of utilization is one of the most important aspects of controlling overall healthcare costs. Methods used vary from weak and mechanical to tightly managed.

Develop a policy and procedure for managing ancillary utilization in a managed care plan. Be specific regarding the type of ancillary service and explain how this policy and procedure will:

  • Maximize resources
  • Contain costs
  • Ensure that appropriate care is provided

Create a presentation for the administration outlining your proposed policy and procedure.

Your presentation should comprise 5 to 7 slides (not including the title or reference slides), and should adhere to the CSU-Global Guide to Writing and APA Requirements. A minimum of three sources should be cited and referenced. Your slideshow presentation should also be accompanied by an audio track. Images used should include the source information in parenthesis below the image. (Example – Source: http: //www.website.com)

Reference:

Kongstvedt, P.R. (2013). Essentials of managed health care (6th ed.). Sudbury, MA: Jones and Bartlett.

Option #2: Disease Management (DM)

Recent years have seen an increase in the use of information technology to make disease management programs more successful. These methods include:

  • Free cell phones for pushing reminders to participants
  • Artificial intelligence programs to predict high-cost patients
  • Automated creation of care plans

Choose one use of information technology that you think will have a significant impact on disease management. Create a presentation for the healthcare administration explaining why purchasing this information technology product would be a worthwhile investment.

Your presentation should include:

  • A discussion of what makes disease management unique
  • A description of the population the product would impact
  • Which component(s) of disease management would be significantly impacted:
    • Recruitment
    • Engagement
    • Interaction
    • Documentation
    • Or another important component of DM

Your presentation should comprise 5 to 7 slides (not including the title or reference slides), and should adhere to the CSU-Global Guide to Writing and APA Requirements. A minimum of three sources should be cited and referenced. Your slideshow presentation should also be accompanied by an audio track. Images used should include the source information in parenthesis below the image. (Example – Source: http ://www.website.com)

Attached is a sample paper

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