Third-Party Reimbursement And Healthcare Finance Topics

Third Party Reimbursement and Healthcare Finance Topics

Discuss the history of third-party reimbursement. Describe the most common reimbursement methodologies used in the past, and then discuss the methodologies that are most common today. Explain the long-term implications for the health care provider, the payer, and the patient, as the method for reimbursement continues to evolve. Remember to use citations and references as appropriate.

Research and discuss the following: · Accountable care organizations. · Value-based purchasing. · Never events. Explain how Centers for Medicare and Medicaid Services (CMS) is trying to improve health care quality with each of these programs. Remember to use citations and references as appropriate.

You are the CFO of a large academic medical center and your organization is in the process of implementing a new electronic health record (EHR) and practice management (PM) system. Review "Perspective 13.5: Financial Benefits From IT," on page 616 of your Financial Management of Health Care Organizations text by Zelman, McCue, Glick, and Thomas. Conduct additional research on the benefits of IT and develop a presentation to convince internal stakeholders to embrace the conversion. Complete a cost-benefit analysis based on Banner Health System's experience, utilizing Plowman's spreadsheet. Analyze organizational opportunities, including potential profits and risks, and discuss improved quality of care. Devise strategies to influence organizational levels and gain endorsement, especially from providers. Identify key stakeholders and approaches to gain support. Evaluate two current state-of-the-art systems used elsewhere that your organization might consider for this transition. Assess how the organization’s strategic position post-implementation relates to technology like hand-held devices, patient portals, etc. Predict provider and patient expectations surrounding the conversion. Develop a strategic plan considering these expectations, aiming for organizational improvement and enhanced community health.

Write a 4–6-page paper discussing three methods of estimating costs in health care organizations, including pros and cons, supported by citations. Complete problem 11a on page 573 related to cost allocation, showing all calculations in an Excel spreadsheet, and include questions or comments. Discuss the importance of a break-even analysis when deciding to lease or buy equipment, including an example, and analyze how fixed and variable costs, indirect costs, and profit influence the analysis. Evaluate stakeholder priorities, potential strategic and financial implications, and how this analysis supports long-term decisions affecting patient care and community health.

Explain the payback method, net present value, and internal rate of return, highlighting similarities and differences, supported by references.

Discuss the benefits and limitations of using bar code scanners in operating rooms for materials management, including responsibilities when items are unavailable or surgeries are canceled. Provide recommendations based on research.

Complete problem 19 a-d on page 287 related to present value calculations at various discount rates, posting your spreadsheet and sharing insights, tips, or learnings. Respond briefly to two peers’ posts discussing their shared ideas or experiences.

Discuss four types of budgets, describing appropriate uses in medical organizations, supported by citations. Respond to two peers’ posts with insights or experiences related to these budgets.

Explain decentralization: its advantages and disadvantages in healthcare organizations, supported by citations. Respond to two peers' posts with their perspectives.

Describe the Affordable Care Act (ACA) of 2010, focusing on how it aims to improve quality, reduce costs, and expand access. Include strategies for stakeholder engagement and community acceptance. Research and report on the act’s impact on community health in your area, supported by citations.

Discuss how you will apply course knowledge in personal and professional contexts, including potential financial impacts and relevant course content.