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Mco In Healthcare

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The healthcare delivery system of the United States is one that is complex and expensive yet still ranks below average in outcomes in comparison to other countries. For the last eight years President Obama has been trying his hardest to find a way in which to make healthcare affordable for all. He created the Patient Protection and Affordable Care Act (ACA) in order to increase health insurance to a large portion of the United States population who otherwise were uninsured. The Affordable Care Act provides US citizens with better health security by putting in place a comprehensive healthcare delivery system that would increase coverage, hold insurance companies accountable, lower costs, guarantee coverage to all, and improve the quality of …show more content…

3). MCO are primarily finance contracts with employers who then provide the option to his or her employees through an HMO or PPO. Although to employer has provided insurance coverage to the employee through a MCO it is up to the MCO to negotiate with providers not the employer (Shi & Singh, 2010, p. 4). The second subsystem of the US healthcare delivery system, military and Veterans Affair system, was put into place to offer active duty military personnel healthcare services at no cost. Such services that are covered are long-term care through the VA, ambulatory care, and routine hospital services (Shi & Singh, 2010, p.5). The vulnerable population system is one that provides healthcare services to those who are uninsured, poor, minority, have an immigrant status, or live in low economically disadvantaged communities. Medicare, Medicaid, Children’s Health Insurance Program (CHIP), and health centers are all examples of insurances that would be found in the subsystem for vulnerable populations (Shi & Singh, 2010, p. 7). One of the last subsystems of the US healthcare delivery system is that of emerging integrated delivery systems. Shi and Singh (2010) describe an integrated delivery system as a coordinated continuum of services to a defined population that is willing to be held accountable both clinically and fiscally for the population’s health outcomes (p. 8). It is evident that the healthcare delivery system of the United States is one that is complex with multiple subsystems for its

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