A client diagnosed with schizophrenia, diabetes, and rheumatoid arthritis is a member of a prepaid health plan. The MOST effective strategy that will promote optimal cost-effective medical care would be for the managed-care nurse case manager to:
a. send copies of all reports and test results to each health care provider on a quarterly basis
b. coordinate scheduling of tests, procedures, and appointments for all health care providers
c. contact the client and health care providers for an update monthly
d. require that the client be restricted to one pharmacy in order to coordinate medications
B
Coordinating the scheduling of tests, procedures, and appointments for all health care providers would be the most effective strategy in optimizing cost-effectiveness under the managed care model. Managed care involves a prepaid health plan in which an intermediary (in this case the nurse case-manager) determines how and from whom the client may obtain services. The nurse's role as coordinator helps prevent excess waste of funds that may occur when the client's care is not managed by a single person (e.g., redundant tests being authorized by two different health care providers not in communication with each other).
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