HCM 320 Milestone Two Guidelines - Copy
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Southern New Hampshire University *
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Course
320
Subject
Health Science
Date
Feb 20, 2024
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Pages
4
Uploaded by ChefTitaniumGull34
HCM 320 Milestone Two Guidelines and Rubric Kenisha Dickelman SNHU Wyatt Gage
In healthcare a social determinant can be anything that affects their health or healthcare outcomes. Factors that can play a role such as their employment, where they are born, age, environment, stress and so on. In this project we will take a closer look at how these factors can play into the fee for service model. When thinking about the fee for service model many would think this is not such a terrible thing. A patient and physician would know what the cost of care would be directly. However, this type of model can create issues in healthcare and with the way the patient receives care. The FFS model can contribute to physicians providing unnecessary tests, services and even medications. Also, with fee for service model of healthcare quantity is measured as reimbursement for payment. Quantity in healthcare does not always suit the patient's needs. This leads to a rise in the cost of healthcare because patients are not always getting the best quality care. With the fee for service model patients are one the ones that feel its biggest impacts. Here is how it goes most of the time. Patient is charged x amount of dollars for a service. Patients' insurance decides not to cover the charge because it is not necessary. However, since the charge is covered by other insurance companies the hospital decides to keep the charge thus increasing the hospital's rate. This charge is just one of many ways that a provider or facility can bill out to increase their revenue. This can have a major effect on lower income patients. With the cost of healthcare going up from fee for service care, low-income patients may cut back on their medical services and medications. One healthcare organization trying to help the change from fee for service to fee for value is The Commonwealth Fund. Their goal is to help improve the quality and efficiency of the most vulnerable in healthcare. This includes people of color, low income and the uninsured.
They do this by supporting independent research and grants. The centers for Medicare and Medicaid services are also taking steps as well. They are taking steps to promote health equity by promoting value based initiatives. References Social Determinants of Health
. Social Determinants of Health - Healthy People 2030. (n.d.). https://health.gov/healthypeople/priority-areas/social-determinants-health Value-Based Care: What It Is, and Why It's Needed
https://www.commonwealthfund.org/publications/explainer/2023/feb/value-based-care-what-
it-is-why-its-
needed#:~:text=In%20other%20words%2C%20they%20are,while%20also%20keeping%2
0costs%20down.
The Case Against Fee-for-Service Health Care –
Third Way
https://www.thirdway.org/report/the-case-against-fee-for-service-health-care
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