Discuss basic components of quality-utilization management


Assignment task: Explain why the following course objectives are important to understanding managed care:

1. Describe the basic components of quality and utilization management, including structure, process, and outcome.

2. Identify and describe the basic structure of governance and management in payer organizations.

3. Understand the basic issues involved with Medicare Advantage and managed Madicaid plans.

4. Describe the basic structure of state and federal oversight of managed care organizations (MCOs).

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