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changes in your member organizations. Public outcry for changes has
been heard loud and long, Congress is calling for reform, and providers
are extremely frustrated with how you control utilization and offer low
reimbursements.
Question 5. 5. (TCO E). You are the VP for human resources and have
been charged to recommend a new healthcare benefits plan that will
improve healthcare services for your employees but manage costs
effectively. You employ approximately 1,800 employees, and the
current health plan provides traditional healthcare services. You want to
expand reimbursement for wellness and prevention services so that you
can improve the health of your employees, thereby saving monies in
your illness coverage, as well as nonproductive time in sick days.
Question 6. 6. (TCO F). You are the Corporate Vice President of
Operations Management for Patient-First Healthcare System, a nonprofit
hospital with seven rural satellite hospitals located within 250 miles of
each other. Your organization has just approved new monies for
developing new quality management initiatives. The individual hospitals
have implemented their own quality management programs with varying
levels of success. Some of their programs demonstrate stellar results and
high levels of patient satisfaction, although others have much less
impressive results.
Question 7. 7. (TCO G). You've just been hired as the compliance
officer for the newly formed Gulf Coast Healthcare System. Your new
employer was formed by the joining of four healthcare organizations –
three acute care organizations and one long-term care agency. Two of
the organizations have a history of various governmental regulatory
violations, as well as suspected fraudulent billing practices. You've been
hired to form a corporate compliance program that includes electronic
billing and medical records that is HIPAA-compliant and will address all
areas of compliance. This plan will not only clean up any issues from the
past but will also position the new organization as an organization with
an impeccable reputation for compliance. Articulate your vision for this
plan and the components that are required for its success. How will you
justify the expense associated with your plan? Keep in mind that you