Assignment task: Request for proposal (RFP) department in an MCO. Several employers have come to you looking for health insurance benefit offerings for its employees. provide a package of health care insurance benefit coverage recommendations based on the size of each company: small group, medium group, and large group.
1. For each company size, recommend the services you would offer that sized company. Include how those services would be organized. You may assume anything you want about the employer. Incorporate your assumptions into your paper.
- Be sure to include such things as what payment systems would be implemented (fee-for-service? capitation? deduction? and so forth).
- How would you incorporate inpatient and outpatient services? How would you handle behavioral health services?
2. There is no one correct answer to this. Demonstrate through understanding the structure, internal operations of MCOs and health care options as presented in the text.
3. What might a small/medium/large group employer look like?
- What sort of financial structure would you recommend?
- What would be the physician relations and so forth?