UMGC Differences between New Reimbursement Models & Prior Traditional Models for Stakeholders Research

User Generated

CEVAPR333

Writing

University of Maryland Global Campus

Description

INSTRUCTIONS

You are the associate vice president for education and training for OtroRaza Health, the academic medical center and health system associated with Enormous State School of Medicine (ESSM). The vice president of medical affairs comes to you concerned about the viability of the school’s residency programs. Several of ESSM’s residency site stakeholders are seeking clarification regarding new reimbursement models being used by the system. Prepare a white paper – for the VP of Medical Affairs to share with the residency sites -- outlining the differences between the new reimbursement models and prior, traditional models for stakeholders.

In your response, include the following:

  • Description of each model, such as capitated payments, fee-for-service, including new and emerging models being introduced to the industry, such as value-based, MACRA, and others.
  • In your review, compare and contrast the traditional and new models and explain the motivation / reasons for the emerging models. Finally, based on this evidence, describe what impact (if any) you perceive there would be on the cost, quality and access to patient care. Support your research with peer-reviewed sources and/or market data. The use of professional charts / graphs to reinforce written content is encouraged. Ensure that your content and information is professional and can be followed by an executive audience.

Several example white paper formats can be viewed at: https://venngage.com/templates/. A free downloadable sample white paper can be found at: https://www.microsoft.com/en-us/download/details.aspx?id=17731.

Note: your product does not need to be this robust, but should follow the same basic framework.

User generated content is uploaded by users for the purposes of learning and should be used following Studypool's honor code & terms of service.

Explanation & Answer

Attached.

1

SAMPLE: Differences between the New Reimbursement
Models and Prior, Traditional Models for Stakeholders.

White Paper

Date: June 2020
Prepared by:

2

Table of Contents
Introduction ........................................................................................................ 3
Fee-For-service Model ............................................................................................ 3
Capitation Model .................................................................................................. 4
Providers are absolved from Patient-Level Value ........................................................... 5
Wrong Risks ..................................................................................................... 5
Limited Patient Choice ......................................................................................... 5
Fee for Service vs. Value Based Care ............................................................................ 6
Alternative Payment Methods .................................................................................... 7
Impact of Evolution of Payment Models ........................................................................ 7
References .......................................................................................................... 8

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Introduction
Historically, the United States has struggled with how to make healthcare payments. The
prominent model of payment, the fee-for-service system, is recognized as an obstacle on how to
improve healthcare in the country. Fee-for-service models reward the quantity rather than quality
of healthcare. Another model is the fixed annual budgets for providers that disconnects budgets
from patient care that arise during healthcare delivery. The problem with fixed budgets is that it
inevitably results into long waits for non-emergency care and creates pressure in the industry to
increase budgets across the year. The decision to adopt value based reimbursement is based on
the move by Centers for Medicare & Medicaid Services (CMS). Value based reimbursement
encompasses different approaches to payment, including capitation and bundled payments. In a
capitation model, healthcare facilities are given annual fixed payments for every covered life and
must fulfil the needs of the patient population. Contrastingly, bundled payments encompass the
payment to providers made for care of patient’s medical condition in the care cycle, in essence,...


Anonymous
Excellent resource! Really helped me get the gist of things.

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