Thursday, September 24, 2015

Healthcare Policy Getting Reimbursed: Its Complicated


Billing and Delivery for health services has become extremely complex. Although fee for service (volume-based care) is deemed to be on it's deathbed by proponents of payment for quality of care and outcomes, the complexity of obtaining a payment becomes more of a juggernaut. This is occuring in the face of  a system that is not ready to convert to accountable care organizations. The infrastructure for such a conversion is completely absent. The marketplace has abundant vendor offerings.  
Although the majority of health providers now are using electronic health records and are required to be certified for meaningful use, many providers are ignoring these standards.  Interoperability remains a major hindrance to  connecting all the systems of an accountable care organization
In order to address this issue and many others take this course.
You will learn about:
  • The relationship between healthcare expenditures and provider compensation.
  • Payment models under Medicare and the Affordable Care Act.
  • The future distribution and cost of healthcare services
  • Define the 3 types of provider payment schemes.
  • Recite the types of national healthcare expenditures and the proportion that each contributes to the total spending.
  • Compare the compensation for US and international physicians as a multiple of gross domestic product per capita.
  • Describe the methods by which Medicare determines physician payments.
  • List the provider components of a healthcare delivery system.
  • Describe how healthcare services will be distributed in the future.
  • List the types of costs associated with healthcare delivery.
  • Describe bundled payments under the Affordable Care Act and how bundled payments are different from prior programs such as global surgical fees.
  • Define the incentives to achieve Medicare bonus pay within a Pay-for-Value program.
  • Review the concepts in the case studies.

Health Care Policy: Delivery and Payment




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