Managed Care Organization (MCO)

Explains the Administrative Role of a Health Care Organization Regarding Oversight of Risk Management Policies and Ensuring Compliance With Managed Care Organization (MCO) Standards

Not included.

An explanation of the administrative role of a health care organization regarding oversight of risk management policies and ensuring compliance with MCO standards is somewhat present, but the information provided is incomplete, inaccurate, or otherwise deficient.

An explanation of a health care organization’s administrative role regarding oversight of risk management policies and ensuring compliance with MCO standards is present, but minimal detail or support is provided for one or more components.

An explanation of a health care organization’s administrative role regarding oversight of risk management policies and ensuring compliance with MCO standards is present, and is incorporated in full. The submission encompasses essential details and provides appropriate support.

An explanation of a health care organization’s administrative role regarding oversight of risk management policies and ensuring compliance with MCO standards is present and comprehensive. The submission further incorporates analysis of supporting evidence insightfully and provides specific examples with relevance. Level of detail is appropriate.

20.0 %Discussion Regarding Assessment of the Value Provided to an Organization That Stems From the Following Aspects of a Typical MCO: Regulatory Statutes, Inclusive of Conflict Resolution and Risk Management Strategies From the Employer/Employee Perspective and Patient Conflict Circumstances

Not included.

A discussion regarding assessment of the value provided to an organization that stems from a typical MCO (regulatory statutes, inclusive of conflict resolution and risk management strategies from the employer/employee perspective and patient conflict circumstances) is somewhat present, but the information provided is incomplete, inaccurate, or otherwise deficient.

A discussion regarding assessment of the value provided to an organization that stems from a typical MCO (regulatory statutes, inclusive of conflict resolution and risk management strategies from the employer/employee perspective and patient conflict circumstances) is present, but minimal detail or support is provided for one or more components.

A discussion regarding assessment of the value provided to an organization that stems from a typical MCO (regulatory statutes, inclusive of conflict resolution and risk management strategies from the employer/employee perspective and patient conflict circumstances) is present and incorporated in full. The submission encompasses essential details and provides appropriate support.

A discussion regarding assessment of the value provided to an organization that stems from a typical MCO (regulatory statutes, inclusive of conflict resolution and risk management strategies from the employer/employee perspective and patient conflict circumstances) is present and comprehensive. The submission further incorporates analysis of supporting evidence insightfully and provides specific examples with relevance. Level of detail is appropriate.

20.0 %Describes MCO Responsibilities Pertaining to the Patient Protection and Affordable Care Act (PPACA) and Center for Medicare and Medicaid Services (CMS) Focus on Fraud, Waste, and Abuse Laws

Not included.

A description of MCO responsibilities pertaining to PPACA and CMS focus on fraud, waste, and abuse laws is somewhat present, but the information provided is incomplete, inaccurate, or otherwise deficient.

A description of MCO responsibilities pertaining to PPACA and CMS focus on fraud, waste, and abuse laws is present, but minimal detail or support is provided for one or more components.

A description of MCO responsibilities pertaining to PPACA and CMS focus on fraud, waste, and abuse laws is present and incorporated in full. The submission encompasses essential details and provides appropriate support.

A description of MCO responsibilities pertaining to PPACA and CMS focus on fraud, waste, and abuse laws is present and comprehensive. The submission further incorporates analysis of supporting evidence insightfully and provides specific examples with relevance. Level of detail is appropriate.

10.0 %Discussion Addresses Course Content and Learning

A discussion that addresses course content and learning is not provided.

A discussion addressing course content and learning is somewhat present, but the information provided is incomplete, inaccurate, or otherwise deficient.

A discussion addressing course content and learning is present, but minimal detail or support is provided for one or more components.

A discussion addressing course content and learning is present and incorporated in full. The submission encompasses essential details and provides appropriate support.

A discussion addressing course content and learning is present and comprehensive. The submission further incorporates analysis of supporting evidence insightfully and provides specific examples with relevance. Level of detail is appropriate.

20.0 %Organization and Effectiveness

7.0 %Thesis Development and Purpose

Paper lacks any discernible overall purpose or organizing claim.

Thesis is insufficiently developed or vague. Purpose is not clear.

Thesis is apparent and appropriate to purpose.

Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

8.0 %Argument Logic and Construction

Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

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