Order ID:89JHGSJE83839 | Style:APA/MLA/Harvard/Chicago | Pages:5-10 |
Instructions:
Assess Health Care Reimbursement Competency Assignment
Describe drawbacks of the fee-for-service reimbursement model.
Describe drawbacks of the capitation reimbursement model as it relates to providing comprehensive services.
Describe how pay-for-performance impacts reimbursement rates.
Describe how resource-based relative value scale or case-based payment encourages an overuse of services.
Competency 4: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with the expectations of health care professionals.
Adhere to the rules of grammar, usage, and mechanics.
Apply APA formatting to in-text citations and references.
INSTRUCTIONS
This assessment is based on the following scenario:
Patient scenario: Your office is seeing a new patient for the first time (new patient consults are $500).
In your role as the reimbursement specialist for a large primary care office, outline the different reimbursement options to which the practice is subject for the providers in the group.
Support your assertions with at least three academic sources. This may require you to do additional independent research. You may wish to consult the Health Care Administration Undergraduate Library Research Guide before you begin any additional research.
This assessment has two parts.
Part 1: Provider Reimbursement Options
Present (at least) the four main reimbursement options that your provider in the scenario would likely have for a new patient consult. Describe the options and comment on potential drawbacks or additional considerations to take into account with each model. Also, consider the likelihood and challenges of recouping the entirety of the consult charges for the patient.
Relevant scoring guide criteria:
Describe drawbacks of the fee-for-service reimbursement model.
“Describe” means to give an account in words of (someone or something), including all the relevant characteristics, qualities, or events.
Describe drawbacks of the capitation reimbursement model as it relates to providing comprehensive services.
Describe how pay-for-performance impacts reimbursement rates.
Describe how resource-based relative value scale or case-based payment encourages an overuse of services.
Adhere to the rules of grammar, usage, and mechanics.
“Grammar” refers to the basic rules for how sentences are constructed and how words combine to make sentences (for example, word order, case, and tense).
“Usage” refers to correct word choice and phrasing, particularly with regard to the meanings of words and phrases.
“Mechanics” refers to correct use of capitalization, punctuation, and spelling.
Apply APA formatting to in-text citations and references.
Be sure to include a separate References page.
One potential way to organize this part would be as follows:
Fee-for-service.
What is it?
Consider health care spending and cost control; what are the drawbacks of this model?
Capitation.
What is it?
What are the potential drawbacks of this model for the physicians who are driven to provide comprehensive services to their patients?
Pay for performance.
What is it?
How does this model impact reimbursement rates?
Resource-based relative value scale or case-based payment.
What is it?
How can this model potentially encourage an overuse of services?
Part 2: Payment Options for Uninsured Patients
Identify and explain the potential payment options that would be available to the patient and your care provider if the patient in for the new patient consult had been uninsured. Also, be sure to discuss the ways that a patient could qualify for specific payment options, as well as the rationale for the associated appointment charge.
Relevant scoring guide criteria:
Explain payment options for uninsured patients, including how the patient would qualify for each option.
“Explain” means to make (an idea, situation, or problem) clear to someone by describing it in more detail or revealing relevant facts or ideas.
Adhere to the rules of grammar, usage, and mechanics.
Apply APA formatting to in-text citations and references.
One potential way to organize this part would be:
Medicaid.
How does the patient qualify?
Financing options.
What is this method?
Self-pay.
How would the patient be charged? A percentage of commercial contracts or a percentage of Medicare?
Charity care.
How would you screen a patient for charity care?
What process would you implement to qualify a patient for charity care?
Assess Health Care Reimbursement Competency Assignment
RUBRIC |
||||||
Excellent Quality 95-100%
|
Introduction
45-41 points The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned. |
Literature Support 91-84 points The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned. |
Methodology 58-53 points Content is well-organized with headings for each slide and bulleted lists to group related material as needed. Use of font, color, graphics, effects, etc. to enhance readability and presentation content is excellent. Length requirements of 10 slides/pages or less is met. |
|||
Average Score 50-85% |
40-38 points More depth/detail for the background and significance is needed, or the research detail is not clear. No search history information is provided. |
83-76 points Review of relevant theoretical literature is evident, but there is little integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are included. Summary of information presented is included. Conclusion may not contain a biblical integration. |
52-49 points Content is somewhat organized, but no structure is apparent. The use of font, color, graphics, effects, etc. is occasionally detracting to the presentation content. Length requirements may not be met. |
|||
Poor Quality 0-45% |
37-1 points The background and/or significance are missing. No search history information is provided. |
75-1 points Review of relevant theoretical literature is evident, but there is no integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are not included in the summary of information presented. Conclusion does not contain a biblical integration. |
48-1 points There is no clear or logical organizational structure. No logical sequence is apparent. The use of font, color, graphics, effects etc. is often detracting to the presentation content. Length requirements may not be met |
|||
You Can Also Place the Order at www.collegepaper.us/orders/ordernow or www.crucialessay.com/orders/ordernow
Assess Health Care Reimbursement Competency Assignment |
Assess Health Care Reimbursement Competency Assignment