1-2 Paragraph 2 hours
1. What is the role of the credentialing committee in a managed care organization? And why is this function so crucial?
2. What is the role of the medical director in a managed care organization? Why is this such a crucial role for the success of the organization?
3. Discuss pay for performance (P4P) in managed care. What are the pros and cons of the P4P approach to compensating providers?
4. What is meant by transitional case management (TCM) under managed care? Provide some specific examples of TCM functions.
5. What is meant by flow-down clauses in managed care contracts? Provide some specific examples