Value Based Model Of Health Care

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The Center for Medicare And Medicaid Services illustrated that the US spends approximately 3.3 trillion dollars on healthcare (1). This translates to $10,348 per person which is almost twice the average healthcare spending per capita when compared to other wealthy countries (1)(2). The high healthcare spending has been an enduring concern for a myriad of American policymakers. To control the rise in healthcare spending there has been a colossal push to transition from a fee for a service-based model to a value-based model. Under the value-based model, hospitals would have to control their utilization, consequently, they would have to reduce their procedure volume and revenues (3).
One of the earliest reforms to move towards a more value-based

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Healthcare Reform

on improving care and lowering cost. The key goal of the healthcare reform is lowering healthcare cost and providing more people to qualify for lower health insurance. When every time new policy is announced and signed into law, many people hope that it will have a positive impact on current issues with the healthcare system. Secretary Burwell states “Whether you are a patient, a provider, a business, a health plan, or a taxpayer, it is in our common interest to build a health care system that delivers…

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Healthcare Management: Cost Effectiveness And Quality Care

Preliminary Copy of Final Project Healthcare Management “Cost effectiveness and quality care” Don Flores Bachelor’s Capstone in Management Professor Reeley Monday, May 14, 2007 Healthcare has changed in the past few decades. The cost of getting and giving healthcare has increased and we are at a point that something needs to be done to make sure the patient gets the care he/she needs to be able to live a quality life. To do this we need to become patient-centered and instead…

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Green Forest Health Case Study

Current Structure of Green forest Health system. Green forest Health system with it’s multiple resources and strengths is uniquely positioned to to adapt to the new model of value based care delivery. Green forest Health system is already participating as a Medicare Shared Savings Plan accountable care organization since 2015. Green forest has employed physicians in many of it’s facilities who can take on the role of PCPs. Some of it’s physician compensation is already tied to ACO quality measures…

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MS-DRG System

payment system is based on Prospective payment system that has been established for determining the Medicare Hospital reimbursements which is a patient classification scheme that provides information related to type of patients a hospital treats (i.e. case mix) and the costs incurred for the hospitals. DRG system primarily based on primary diagnoses, secondary diagnoses, surgical procedures, age, sex and discharge status of patients. This DRG system assigns a numeric value for the acute care…

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Health Care Reform Case Study

healthcare payers, providers, and other stakeholders to seek innovative payment models which emphasize quality care at a reduced cost. Although the payment reform may seem confusing, it has only one goal and that is for economic incentives to encourage value over volume. These new payment models vary from the traditional fee-for-service model of reimbursement which provides incentives for volume and visit- based care. Each payment model has its incentives and disincentives. Therefore, a good understanding…

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The Role Of Social Determinants In Healthcare Finance

topic of debate and argument with discussions surrounding access, affordability, and quality of care. Under the current presidential administration, efforts have been made to create a healthcare plan that addresses these issues and improves the overall well-being of the population. A crucial aspect of healthcare policy is recognition of social determinants of health, which can impact an individual’s health outcome. It is essential to examine how social determinants are evident in existing healthcare…

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Concept Of Patient Centered Medical Home

medical home (PCMH) is “a care delivery model whereby patient treatment is coordinated through their primary care physician to ensure they receive the necessary care when and where they need it, in a manner they can understand.” It is said to be broken down into five functions and attributes which consist of comprehensive care, patient centeredness, coordinated care, accessible services and quality/safety. Although some of these practices vary in sizes, the health care teams are built so that they…

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POSC Health Care Assignment Essay

Michael Bragat Andrea Pulido Political Science December 10th, 2014 Gallucci Health Care Policy Proposal 1. What is the name of your Health Care Plan? Why have you chosen this name? a. The name we chose for our Health Care Plan is the Feel Good Policy. The name is an inviting one and gives a universal understanding of the goal of the policy, which is for everyone in the United States to “feel good” about their health. and to feel like they have the tools to live a long and healthy life . 2…

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CMS Core Measurement Analysis

As health care systems move toward improvement in quality of care via value-based reimbursement models, there has been an increase in demand for accurate information on healthcare quality, which can be used as a guide for consumers, employers, physicians and policymakers (Core Measures, 2016). Many find it difficult to find useful health care quality information due to the fact physicians are required to report to several different organizations; all of which may follow different measure requirements…

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The Patient Protection And Affordable Care Act

Obama signed into law H.R. 3590, the Patient Protection and Affordable Care Act. Since the induction of the Affordable Care Act the Mayo Clinic reached a new goal of 63 million patient services in 2013. (Mayo Clinic , 2014) There has been substantial growth as seen in 2011 they reported just over 20 million patient services. (Mayo Clinic , 2014) The Affordable Care Act has allowed those patients that could not afford health insurance and or issues with pre-existing conditions to finally be able…

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