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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