Describe the basic components of quality and utilization management, including structure, process, and outcome.
For each of the lessons you were presented with two required readings. Choose one required reading article from each lesson and summarize the article and explain its importance to understanding managed care.
Explain why the following course objectives are important to understanding managed care:
Describe the basic components of quality and utilization management, including structure, process, and outcome.
Identify and describe the basic structure of governance and management in payer organizations.
Understand the basic issues involved with Medicare Advantage and managed Medicaid plans.
Describe the basic structure of state and federal oversight of managed care organizations (MCOs).
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