health care polices and resource allocation ii h 440

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Managed Care Organizations and Information Technology

The most important function of information technology (IT) for the managed care organization (MCO) is to support the business of the MCO. How the IT department aligns with the operational dynamics of the MCO is a vital management consideration. A well-functioning IT department will help the MCO reduce risk (e.g., costs). The IT department should design, implement, and operate the systems that run the MCO. Efficiency is the hallmark of a good system.

Your task as the manager of the MCO is to determine what the IT department in your organization should consist of, what its function will be, and what critical elements will be turned over to the IT department. Complete the following:

  • Describe the key elements of an information system for an MCO. What elements are different than for a physician office or group?
  • Describe the technology that you think the MCO would need to operate fully.
  • Propose a specific electronic health record (EHR) or electronic medical record (EMR) program that is Health Insurance Portability and Accountability Act (HIPAA) compliant. Describe the essential functions, costs, and projected savings for the MCO.
  • Evaluate the strengths and weaknesses of insourcing versus outsourcing your IT needs, and make a final recommendation based on that evaluation.

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