https://www.mediafire.com/file/2ue669i2pirwtyh/Final+Examination.docx/file these are the questions above https://www.mediafire.com/file/03lrwentvm2mune/The+Rise+and+Fall+of+Medicaid+Managed+Care.p

Total Points

Points Lost

Based on Chapter 19: Health Care Fraud and Abuse

1. What types of steps can managed health care plans take to improve their ability to detect fraud?

10

Based on Chapter 20: Member Services

1. Describe the legal and regulatory milieu affecting member services, and provide hypothetical descriptions of different scenarios to illustrate those effects.

15

Based on Chapter 23: Information Systems and Electronic Data Interchange in Managed Health Care

1. Describe and discuss a data warehouse and its key attributes.

10

Based on Chapter 24: Health Plans and Medicare

1. Discuss the approaches CMS uses to monitor plan performance, as well as how CMS uses this data to address any performance issues.

15

Based on Chapter 25: Medicaid Managed Health Care

1. Why has the extension of Medicaid managed care to "special need populations" been so slow and why is it now becoming a more prominent priority?

5

1. What factors are contributing to greater reliance in the future on managed care models in state Medicaid programs?

5

Based on “The Rise and Fall of Medicaid Managed Care in Mississippi: Lessons for Public Health Policy Makers,” what caused the demise of the program and what lessons can be learned for policy makers

20

Total points lost

Grade based on 100

Grade based on 20%