Foundations of Managed Care Due Thursday 12/18/2014

Medicaid managed care serves a population with complex needs. List and explain two operational challenges faced by Medicaid managed care.


Members contact their health plans for a variety of reasons. List two of these reasons.

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Administrative claims data can serve many different uses for reporting and analysis in managed care. List two potential use.


List two examples of tools that a health plan can use to promote disease prevention among its members.


List two advantages and two disadvantages for a health plan using a PBM to manage its pharmacy services rather than developing or building these services internally

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