What kind of risk do the MCOs assess?
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- What kind of risk do the MCOs assess?
- Does risk-based compensation limit the freedom of primary care physicians in any way in terms of patient care? Why or why not?
- How does the capitation model of reimbursement work? Do physicians generally prefer one model over the other? Why or why not?
- Why do HMOs prefer the prepaid, monthly premium?
- Is pay-for-performance a better model than existing models of compensation? Are there limitations to it as well?
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- Healthcare administrators should be well versed on policies affecting healthcare financing at the federal and state levels. Healthcare organizations need to assess the financial impact that a volume-to-value transition (VVT) will cause to their facility, the staff, and the patients. Who benefits from moving healthcare from volume to value? What are the factors a healthcare administrator must take into consideration when deciding to transition to a volume-to-value model? How are the financial impacts HCOs face who are currently using this model?When considering cost-reduction initiatives in healthcare,what are the services with the greatest potential to reduce costs?Which of the following are set up to monitor all areas of care that tend to cause problems? a. Internal Report Forms b. Quality indicators c. Sentinel events d. Threshold values
- Discuss some of the global, local, historical, and/or current issues that make quality healthcare delivery such a complex process. What are some of the suggested changes from this week's readings or outside sources that you think would have the biggest impact? use at least 3 scholarly articles no more than 4 years oldAssumptions: Plastic Surgery Practice 2 Surgeon, 2 Nurse Practitioner Practice 1 Front Desk Staff Member (Check In/Check Out) 5 Medical Assistants 2 Surgery Schedulers 2 Administrative Assistants 1 Practice Manager 1 Coding/Billing Staff Member Physician 1 Patient Collections: Physician 2 Patient Collections: Nurse Practitioner 1 Collections: 250,000 Nurse Practitioner 2 Collections: 150,000 Physician 1 Compensation: 550,000 Practice Manager Compensation: Coding/Billing Staff Member Physician and Staff Fringe Benefit Rate Supplies Expense: Drug Expense: Rent Expense: Utilities Expense: Physician 2 Compensation: Nurse Practitioner 1 Compensation: 150,000 Nurse Practitioner 2 Compensation: 110,000 Front Desk Staff Member Compensation: 40,000 Medical Assistant Compensation: $35,000, $40,000, $40,000, $45,000, $48,000 Surgery Scheduler Compensation: $40,000, $45,000 Administrative Assistant Compensation: $35,000, $38,000 $70,000 Depreciation Expense: Malpractice Expense: $1,200,000…Discuss how a practice, workplace, education, or research situation in your experience was directly affected by health policy decisions or allocations. What are the options for changing that policy? What are the barriers and facilitators to changing the policy?
- What risk and quality management tools do you use to interpret or present the data for long wait times for patients to see their healthcare providers?What are the best evidence-based interventions to support public health education?What are some examples of measures in the Effectiveness Domain? Select all that apply. 1.Percentage of patients receiving recommended hospital care for heart attacks 2.Percentage of patients receiving recommended preventive care 3.Rates at which patients fall 4.Percentage of health plan members receiving screenings for cancer
- What are the phases of the revenue cycles for healthcare billing?You have just been appointed CEO for a 250-bed community hospital in the Midwest. It is has been 8 years since your organization conducted a full community health needs assessment (CHNA). Your facility is behind the times, and you have your work cut out for you. You are very interested to see how your community is faring compared to the Healthy People 2020 objectives. What aspects will you study to see how your community measures up to the Healthy People 2020 objectives? Your journal entry must be at least 200 words in length.how does cost-shifting impacts the flow of hospital monies?