Managed Care and Health Insurance Week 2 Discussion Questions (6)
Experts only! Scholarly responses are required.
*Please answer each question individually and accurately. Must cite any and all references in APA
format. Label each solution with the corresponding question. Copy and pasted solutions will NOT be
accepted. Minimum 2-3 quality paragraphs per question
Part A: Provider Networks
1. Why do managed care organizations seek to establish a provider network? What are the primary
reasons for contracting with providers?
2. What is the incentive that providers would have to contract with a plan?
3. What limits the number of providers that managed care networks will be willing to add?
Part B: Legal Issues in Provider Contracting
1. Describe and discuss the key issues associated with provider payment that should be addressed in any
managed care contract.
2. If you were negotiating for the provider, what would you be most interested in pursuing?
3. If you were negotiating for the managed care organization on this issue, how would you convince the
provider to accept a particular rate of reimbursement?
