225831-Real-World-Case-Analysis-edited-docx
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Chamberlain University College of Nursing *
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242
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Health Science
Date
Jun 23, 2024
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docx
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Running head: CASE
1
Real World Case Analysis
Student
Institution
CASE
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Real World Case Analysis
Moving a Physician Group from Fee-For-Service Towards a Value-Based Focus
Changing revenue models with regard to physicians is very costly and far-reaching. Fee-
for-service models reward physicians for each service they provide, which frequently results in an excess of procedures and disjointed patient care. Value-based care emphasizes quality rather than quantity and matches the incentives of all stakeholders to patient outcomes. The economic model could allow doctors make money by using methods that will lead to improved health of patients, preventive care, or affordable and appropriate treatment methods. Several reasons are evident on why physicians would like to join Chillax. Therefore, moving towards the value-
based model facilitates a more integrated and patient-specific workflow for physicians who desire to have a profound effect on their patients' well-being. The second reason is that there will be low pay due to dropping insurance payments under a fee-for-service scheme. Working for an outward-looking entity such as Chillax guarantees financial security and growth opportunities. The balanced mix is what matters in incentives critical for PCPs and specialist groups. Physician resistance could be prevented by linking financial incentives with measures of quality, patient satisfaction, and costs. Another key aspect is to show support during the change, like through training and technology devices. Additionally, it is important to ensure that the change does not interrupt the fee-for-service operation of the organization. Assuaging this concern could be achieved by providing a smooth shift whereby physicians can retain part of their income in the fee-for-service system throughout the transformation period.
Addressing Physician Compensation Changes in A Medical Group
Physician compensation models become important because they ensure that financial incentives for quality are part of meeting the general objective of providing medical attention
CASE
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services, which is providing good health for patients. Within the context of a value-based system,
quality metrics establish standards, compelling doctors towards preventive medical services, patients’ welfare, and health results. The change is vital in fostering a just and rewarding system which appreciates doctors’ performance rather than the number of services offered. Ideal candidates for leading compensation changes among physicians who have significant roles in community-based healthcare systems that drive down costs and improve the overall quality of care. PCPs have a primary role in preventative medicine, while specialists play an integral position regarding cost-effectiveness and patient results.
Forming A Multi-Organizational Clinically Integrated Network (CIN)
The cost of investment in building the CIN, as well as its governance and collaboration with payers, should be considered in business implications for Chillax. A financial commitment is inevitable whenever a partner is selected but it also helps in aligning incentives in partnership which Chillax's joint venture has exhibited. A collaborative approach in collaborations with other
entities may meet some challenges such as rivals' unwillingness to back another competitor's objective (Sanchis, Sanchis-Gisbert & Poler, 2020). Some benefits of collaborating with the buyer include the opportunity to share financial risk and align incentives. However, disadvantage
cases include instances of conflict of interest or dependence on a single-payer. Other options include partnering with a venture capital entity, fundholders, or establishing a joint organization between the company and a healthcare system.
Sharing Finances in a CIN
Chillax CIN will design the financial dashboard which will monitor KPI’s like revenue distribution, contract performance and overall financial health. KPIs should include:
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