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HCAD 640 Health Insurance Managed Care and Reimbursement Responses

HCAD 640 Health Insurance Managed Care and Reimbursement Responses

Hi, please, read and contribute to peer discussion in 100 words minimum with at least 2 credible references: Peer 1: Porter and Lee (2016) states quality of care and lower cost are possible and can be beneficial to all players, by implementing and applying 3 basic calculated moves into a healthcare system. The University of Utah Health Care Team implemented: 1). “value improvement became the organizations business model; 2). organize work around specific patient conditions, and 3). organizations create multidisciplinary teams to drive the improvement effort”. (Porter and Lee, 2016). Cohen and Reifsnyder (2021) states there are 5 steps a healthcare system must take in order to become value based and all players reap the benefits: 1). patients are put in groups based on their needs, 2). provides organize into multidisciplinary teams to take care of the groups, 3). teams must measure health outcomes, and services cost, 4). upgrade IT systems with appropriate tools to collect data corrections, expense tracking and communicate between providers, 5). providers and payers change how they bill patients. Patients benefits from a value-based healthcare by receiving care that is focus on what matters to them, better health outcomes throughout their illnesses, needs will be solved, and care at a lower cost. (Cohen and Reifsnyder, 2021). Providers benefit from a value-based healthcare by reduction in burnout, reduction in paperwork, increase time with patients, providing structured and better care, and improves the providers’ experience. (Cohen and Reifsnyder, 2021). Payers benefit from a value-based healthcare by decreasing paperwork, stronger cost controls when paying for patient services, reduced client risk, creates a healthier population fewer services and reduced cost. (Cohen and Reifsnyder, 2021). Society benefits from value-base healthcare when it becomes the model for healthcare systems, quality will improve, healthcare cost per person will decrease, and it will improve the overall health of the population. (Cohen and Reifsnyder, 2021). In conclusion I believe Porter and Lee (2016) and Cohen and Reifsnyder (2021) were speaking the same language about quality of care and lower cost is possible in a value-based healthcare system. Healthcare systems, leaders, and lawmakers in the U.S. just need to get to that mindset and implement the necessary steps to achieve it. References Cohen, A. and Reifsnyder, C. (2021). How Value-based Care Benefits Patients, Providers, Payers and Society. Retrieved from https://veradigm.com/veradigm-news/value-based-care-benefits-patients-providers-payers-society/#:~:text=Value-based%20healthcare%… Porter, M.E. and Lee, T. H. (2016). From Volume to Value in Health Care. JAMA 316(10). 1047-1048. Retrieved from https://www.waportal.org/sites/default/files/resources/From%20Volume%20to20Value.pdf Peer 2: Healthcare organizations need to correlate the cost of care with quality outcomes to effectively balance the delivery of quality patient care at a reasonable cost (Imus, 2014). Correlating cost with care can benefit both the providers and patients in many ways (Porter & Lee, 2016). When cost is correlated with quality, patient satisfaction tends to increase. Correlating cost with quality encompasses reducing medical errors and rewarding the best-performing care provider organizations. Historically, limited incentive attempts, such as overall price discount negotiations, have not improved the quality of care. Correlating cost with quality links specific objectives to reimbursement incentives. Patient satisfaction is an important benchmark that health care administrators use to measure organizational performance. Duly, hospitals linking cost to quality increase satisfaction with healthcare plans and service delivery. Correlating cost with quality combines patient outcomes and medical cost data in a meaningful, actionable way (Houlihan & Leffler, 2019). Ideally, the outcomes produced by linking cost to quality result in improved patient health care services, satisfaction with insurers, and care providers that can compete capably in a competitive marketplace. Correlating costs to quality is a powerful method for countering physician burnout. That’s because it implements several key changes to healthcare practice that help fight burnout. For instance, one common complaint physicians raise in a fee-for-service environment is the high volume of documentation they must produce (Houlihan & Leffler, 2019). Physicians spend time and energy on administrative work, and charting takes time away from patient care. Providers are also rewarded for their performance compared with all other providers, or for how well they improved their own performance compared with performance during a baseline period (Kristin & Paula, 2021). References Imus, S. (2014). Healthcare Cost Accounting: Strategies to Streamline Implementation and Quickly Achieve Measureable Results. Houlihan, J., & Leffler, S. (2019). Assessing and addressing social determinants of health: a key competency for succeeding in value-based care. Primary Care: Clinics in Office Practice, 46(4), 561-574. Kristin L. Reiter, & Paula H. Song. (2021). Gapenski’s Healthcare Finance: An Introduction to Accounting and Financial Management, Seventh Edition: Vol. Seventh edition. Health Administration Press. Porter, M. E., & Lee, T. H. (2016). From volume to value in health care: the work begins. Jama, 316(10), 1047-1048. Please, respond to Peer 3 below: Hi, great post and very informative. I agree increasing the quality of healthcare could help reduce costs by improving patient outcomes. The bundle payment system can do just that, not only does the patient benefit the providers will also. Struijs et al.,(2020) research consisted of data from 23 bundled payment systems initiatives around the world that’ reported positive cost-saving effects and quality of care for the patient due to the bundled payment system’. Porter & Lee (2016) agree with Struijs (2016) that cost accounting system by identifying an ‘opportunity index’ for the healthcare system. The index recognizes diagnosis, high cost, and variability, physician needed to care high-cost patient care. The end results according to Porter & Lee (2016) was by utilizing the bundled payment system would improve quality of care, reduce mortality and readmission rates, also healthcare and cost. References Porter, M.E., & Lee, T.H. (2016). From Volume to Value in Health Care: The Work Begins. JAMA, 316(10), 1047-1048. https://www.waportal.org/sites/default/files/resources/From%20Volume%20to%20Value.pdf Struils, J. N., Vries, E., Baan, C., Gils, P. and Rosenthal,M. (2020). Bundled-Payment Models Around the World: How They Work and What Their Impact Has Been. The Commonwealth Fund. https://www.commonwealthfund.org/sites/default/files/2020-04/Struijs_bundled_payment_models_around_world_ib.pdf

Mastering the Art of Online Learning: Your Guide to Acing Online Courses

Mastering the Art of Online Learning: Your Guide to Acing Online Courses

Introduction

In recent years, the popularity of online courses has skyrocketed, offering learners the flexibility to acquire new skills and knowledge from the comfort of their homes. However, succeeding in online courses requires a different approach compared to traditional classroom settings. To help you make the most of your online learning experience, this article presents essential strategies and tips to ace your online courses.

1. Set Clear Goals and Plan Ahead

Before embarking on an online course, establish clear goals and objectives. Determine what you hope to achieve by the end of the course and break down your goals into manageable milestones. Create a study schedule that aligns with your other commitments, ensuring you allocate dedicated time for coursework, assignments, and revision.

2. Create a Productive Study Environment

Establishing a conducive study environment is crucial for online learning success. Find a quiet, well-lit space where you can concentrate without distractions. Remove any potential interruptions, such as notifications from social media or email. Organize your study materials and have a reliable internet connection to ensure seamless access to course materials.

3. Actively Engage in the Course

Active participation is key to mastering online courses. Engage with course materials, including videos, readings, and interactive components. Take comprehensive notes, highlighting key concepts and ideas. Participate in discussion boards, forums, and virtual meetings to interact with instructors and peers, fostering a sense of community and enhancing your understanding of the subject matter.

4. Manage Your Time Effectively

Online courses offer flexibility, but it’s essential to manage your time wisely to avoid falling behind. Create a detailed schedule, allocating specific time slots for coursework, assignments, and studying. Break down larger tasks into smaller, manageable segments to prevent procrastination. Prioritize tasks based on deadlines and dedicate focused time to each one, ensuring consistent progress throughout the course.

5. Develop Effective Communication Skills

Online courses often rely on written communication, making it crucial to hone your skills in this area. Be concise and clear in your written responses, paying attention to grammar and spelling. Actively participate in discussions, asking thoughtful questions and providing constructive feedback to your peers. Regularly check your course emails and notifications, ensuring you stay updated with any important announcements or changes.

6. Utilize Available Resources

Take full advantage of the resources provided by your online course platform and instructors. Familiarize yourself with the learning management system (LMS) and explore its features. Access supplementary materials, such as textbooks, lecture slides, and external resources recommended by instructors. Utilize online libraries, research databases, and tutorial services to deepen your understanding of the subject matter.

7. Stay Motivated and Engaged

Maintaining motivation throughout an online course can be challenging, particularly when faced with competing priorities or a lack of face-to-face interaction. Set short-term goals and reward yourself upon their completion. Connect with fellow learners through virtual study groups or online forums to foster a sense of camaraderie. Regularly remind yourself of the benefits and personal growth associated with completing the course successfully.

8. Seek Support and Clarification

Don’t hesitate to seek support or clarification when needed. Reach out to your instructors for guidance or clarification on course material. Utilize online discussion forums to ask questions or engage in collaborative problem-solving. Leverage the support services provided by your course platform or institution, such as technical support or academic advising.

Conclusion

Online courses present unique opportunities for self-paced learning and personal growth. By setting clear goals, creating a productive study environment, actively engaging with course materials, and managing your time effectively, you can maximize your chances of acing online courses. Remember to stay motivated, seek support when needed, and make the most of the available resources. Embrace the flexibility and adaptability of online learning to achieve your educational goals.


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