Week 2 you decideWhat’s this?Scenario/SummaryYou are the chief executive officer of Southside HMO, which serves 495,000 members throughout the eastern region of the United States. It has c

Week 2 you decide

What's this?

Scenario/Summary

You are the chief executive officer of Southside HMO, which serves 495,000 members throughout the eastern region of the United States. It has come to your attention that several members or patients who participate in your plan have filed a complaint that your HMO plan does not provide quality healthcare delivery. Several patients have been denied healthcare services to see specialists to whom they were referred by their primary care providers.

Your Role/Assignment

The board of directors has asked that you provide a 750-word report detailing your strategies and recommendations to investigate the complaints and to identify strategies to ensure that quality management initiatives are in place to make sure that quality healthcare services are provided to all members. The strategies and recommendations should be as specific as possible and include the resources needed for implementation. Your primary text and journal and website research must be used as a reference to support your analysis.

Key Players

Review the points of view of the following people to obtain further insights on this assignment.

Dr. Waters Primary Care

I have been providing healthcare to patients at Sunnyside Hospital for 5 years, and the hospital recently started contracting in network with Southside HMO. Southside is denying referrals to specialists for medical treatment.

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Mrs. Brown Patient Advocacy Group Representative Sunnyside Hospital

I represent patients at Sunnyside Hospital, and more than 30 patients have informed me that Southside HMO is not complying with primary care provider referrals to see a specialist.

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Mr. Robins Mr. Robins CEO Southside HMO

I have been the CEO of Southside HMO for 10 years, and I ensure that our organization is in compliance with all quality management initiatives.

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Category Points % Description

Content 10 20 Content is excellent, completely consistent, and appropriate for audience and purpose; content contains excellent internal integrity; detail is rich and specific.

Organization 10 20 Organization is excellent; ideas are clear and arranged logically and the transitions are smooth; there are no flaws in logic.

Design and Format 10 20 Document format is excellent, with strong visual impact, design, and format.

Style and Readability 10 20 Readability is excellent, with strong attention to audience, appropriate tone and style, and good transitional language; there is good use of figurative language.

Grammar and References 10 20 Grammar, referencing, punctuation, mechanics, and usage are correct and idiomatic, consistent with Standard American English; content demonstrates competent use of mechanics.

Total 50 A quality paper will meet or exceed all of the above requirements