You are the new CFO, of UMUC Medical Center, a 120 multi-skilled level three (3) healthcare facility. You have summoned a team of healthcare and business experts to assist with the process of contract negotiating. Based on the federal mandate of the Affordable Care Act (ACA), prepare a proposal summarizing the team’s final recommendations in preparation for an upcoming meeting. 

Devise a proposal that addresses the following:

• Present a four to five (4-5) page proposal recommending the team’s final decision based on the review of National Committee on Quality Assurance (NCQA), 2016-2017 health insurance plans rating that can be located directly at http://healthinsuranceratings.ncqa.org/2016/Default.aspx. The proposal must identify the following:     
  • Conduct a one (1) page analysis of the ACA and its future implications on managed care organizations (in particularly in reference to reimbursement)
  • Create a one (1) page checklist that will be utilized as a tool to review managed care contracts presented to the organization.
  • A one year (1) financial analysis as a predictive measure/tool projecting the financial performance based on the adoption of the selected health plan and reimbursement model [based on fictitious data and figures]
  • Identify at minimum three (3) involved parties the team recommends as a contributing player in the review of all managed care contracts under consideration. Briefly, support your reasoning for each recommended person to participate in the review.
•  Submit one (1) single Microsoft Word document

provide a meaningful response to at least two of your peers’ posts by the end of the week. In your responses to your peers, you might offer a perceived roadblock to the individual’s ability to learn.

Peer # 1 Tamira Parker                          

1.An individual who has recently been diagnosed with lung cancer has a need for information about the stage of the cancer, treatment options, and odds of survival. This individual could use a lot of support during this rough time.

2. A family caring for an elderly individual with AD needs to learn positive coping mechanisms to deal with the family member, taking a break when they feel exhausted, and support groups. Support groups can help the patient and or family to meet other people that are going through the same exact thing.

3. A community in which adolescent cigarette smoking is on the risk adolescents need to be educated on the risks associated with smoking such as lung cancer and heart disease. If guidelines permit refer the adolescent to counseling to see if there is a possibility that smoking is secondary to another issue. Also refer adolescent to cessation programs if guidelines permit, if not discuss with parent and decide what is in the best interest of the child.

Peer #2 Samantha Pearce                           

An individual who has recently been diagnosed with lung cancer. Start off by informing the patient of the different type of treatment. Immunotherapy is a type of cancer treatment that works by boosting or activating your immune system, so it recognizes and kills cancer cells. Also, there are lots of active support groups for patients and family caregivers, so no one has to face a lung cancer diagnosis alone. Furthermore you would teach/inform the patient how to cope with these emotions by communicating with your friends and family members, expressing your thoughts in a journal and quitting smoking, eating right, staying physically active and managing your stress helps your body stay healthy.

A family caring for an elderly individual with Alzheimer’s disease. Teach the caregiver that they must understand how AD changes a person, learn how to cope with these changes. Make the home safe for the person with AD. Caregivers could also find out about helpful resources, such as websites.

A community in which adolescent cigarette smoking is on the rise. It is well known that tobacco use increases the risk for contracting a variety of diseases and health conditions, including lung, bladder, colorectal, esophageal, kidney, larynx, mouth, throat and other cancers, respiratory infections, diabetes, and coronary heart disease. A Campaign for an adolescent young girl is good to inform the public of these risks, combined with smoking legislation regulating the age of access and smoking in public places have led to a general decrease in smoking prevalence among all age groups.