SCENARIO: You are responsible for the request for proposal (RFP) department in an MCO.
Several employers have come to you looking for health insurance benefit offerings to their employees. You are to provide a package of health care
insurance benefit coverage recommendations based on the size of each company:
small group,
medium group,
and a large group.
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?
For each company size, your paper should be about 2 to 4 pages in length. Double-space and use 1-inch margins all around in 12 point Times New
Roman font.
Use headers freely to help outline your various recommendations for structure and content
There is no one correct answer to this. Your task is to demonstrate through this assignment that you understand the structure, internal operations of
MCOs, and health care options as presented in the text.
When writing, consider these questions:
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?
Use the text as a guide as to other factors that should be included in your paper. Details are good here.
Sample Solution