Colorado Technical University Individual Project Healthcare Management Discussion

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Business Finance

Colorado Technical University


“The complexity of financing in health care is one of the primary characteristics of medical care delivery in the United States” (Shi & Singh, 2012, p. 129). There are numerous reimbursement methods (e.g., capitation, fee-for-service, package pricing, etc.) that are used by health care organizations and providers to get paid for the health care services that they provide. Building upon your Individual Project from Unit 1, write a 3-5 page paper not including a title page and reference page that contains the following:

  • Summarize 3 different reimbursement methods that are used by health care providers and organizations.
  • Choose which method(s) will work best for the health care facility that you have proposed to be developed, and explain why you chose that method(s).
  • Discuss the pros and cons of the reimbursement method(s) that you chose.
  • Discuss the impact that the method(s) may have on the financial operations of the facility that you chose.

Note: You should include a minimum of 3 references, properly cited in APA format.

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Explanation & Answer

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Unit 2 - Individual Project Healthcare Management
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In the United States, urgent care providers are still evolving, which has increased
reimbursement methods they use to get paid for the health care services they provide. However,
it is essential to note that financing healthcare in the United States has been challenging. How
providers get paid is an imperative topic and a reformed facet of the American healthcare system
(Oleske et al., 1998). Concededly, are providers been paid a lot of money? Are the methods of
payments making them relaxed in their service provision to patients? This paper will discuss the
common reimbursement methods used by health care providers and organizations.
One of the most common reimbursement methods used by providers is a fee for service
(FFS). This reimbursement method is practically based on what providers carry out procedures.
Every individual service given to a patient has a corresponding code that has a price attached to
it. Moreover, how a healthcare provider is paid for a particular service is based on the insurance
of the patient in need of care (Oleske et al., 1998). For example, when dealing with Medicaid or
Medicare, the prices are determined by Centers for Medicare and Medicaid Services (CMS). On
the other hand, priva...

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