Week 4 You Decide
Health Ins and Managed Care
Keller Graduate School of Management
It is evident that ABC and Verde Greene are both striving to achieve the highest level of success. For example, the ABC Insurance Company has been very aggressive and quite successful in recruiting companies, organizations, and individuals to join its managed care plans. Their ranges of services and rates have been extremely competitive. Their employer base is spread out among the 14 counties, which has been attractive to many employers. They have also achieved success in selling its managed care insurance program to employers and organizations. Verde Greene Hospital, however, has an excellent reputation for quality in maternity care, cardiac rehabilitation, and orthopedic medicine, and it is the only hospital in town to have received the Magnet Award for Excellence in Nursing. A sizable number of employer groups as well as employees, who have insurance coverage with ABC Insurance Company, want Verde Greene Hospital to be included in the network as a participating hospital. Despite the agreement that The ABC Insurance Company and Verde Greene Hospital made, there are many issues that could drastically affect both parties if this agreement were to be signed. It appears that as neither Verde Green, nor ABC considers how this agreement would impact patients in regards to quality of care or medical staff in regards to losing patients. With that said, ABC should consider renegotiating the terms of the agreement in which they are in the process of making with Verde Green. The agreement in question, would not benefit the majority of the patients base that require cardiac or maternity services given the amount of traveling that the patients would have to do in order to receive care. As a result, the insurance company must express the fact that they are unable to meet the stipulations in which Verde Greene requested for...