There are a great many issues associated with adapting to local conditions that U.S. Managed Care Organizations (MCOs) abroad have had to face. Issues include:

• Lack of standardized coding systems
• Established lines of physician income that are threatened by managed care
• Cultural sensitivity

Explain which issue you believe poses the greatest challenge and discuss a strategy that could be leveraged to deal with this issue. Refer to the text and past experiences as you provide evidence to support your response.

250-350 words