...Reimbursement and Pay-for- Performance Edward G. Walker HCS531 May 26, 2014 Tracey Lane Reimbursement and Pay-for- Performance This paper will define Pay-for- Performance; I will explain how reimbursement is affected by Pay-for- Performance approach. I will discuss how system cost reductions impact the quality and efficiency of healthcare. I will discuss how Pay-for- Performance, effects healthcare providers and their customers. I will discuss the effects of Pay-for- Performance and the effect it will have on the future of healthcare. First we must understand what reimbursement and pay performance is. Pay-for-performance is referred to as an umbrella term with performance initiatives that are designed to improve efficiency, quality of the health care system. Pay-for-performance is a reimbursement plan that links payment to quality and effectiveness as an initiative to improve the quality of healthcare and reduce costs. Reimbursement is what the insurance company will pay to the provider and the reimbursement may be only a partial amount of what the actual charges. (Health Affairs, 2012) How is reimbursement affected by the pay for performance approach? This reimbursement method is a where some providers and hospitals pay better than other healthcare facilities for the same service. Their patients appear to have better health outcome results. The two main objectives are; (1) To increase the overall quality of health care that a patient receives. (2) To encourage...
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...Pay-for-Performance University of Phoenix HSC/ 531 * Paper includes the following: Defines pay-for-performance. Explains how reimbursement is affected by the pay-for- performance approach. Discusses how system cost reductions impact the quality and efficiency of health care. Discusses how pay-for-performance affects health care providers and their customers. Discusses the effects pay-for-performance will have on the future of health care Pay-for-Performance is 1,400 to 1,750 words in length Even though the effects of pay-for-performance will influence the future of health care in patient care, reimbursement to the healthcare providers will require close monitoring. The physician receives reimbursement for providing quality care and for making quality innovations. Pay-for-performance offers financial incentives to close the gap in healthcare the patients receive and the healthcare the patients could receive. The effect of pay-for-performance for the healthcare providers depends on his or her quality and efficiency of services he or she provides to the patient. The consumer groups, government, and patients are actively applying pressure on healthcare organizations to lower the costs, improve patient safety and care, and to enhance services (Shi & Singh, 2012). Definition To define the pay-for-performance in the healthcare payment system is rewarding the providers who achieve, improve, and exceed his or her performance on quality and lower the cost. ...
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...Reimbursement and Pay-for-Performance Paper Patricia Vandermark HCS/531 November 3, 2014 Connie Melton Reimbursement and Pay-for-Performance Paper The arena of health care has always been constantly fluid, dynamic, and extremely challenging. As health care providers we struggle with the increasing demands of our institutions, the increasing demands of our patients, and most recently the demands that are a direct result of today’s health reforms. Since the inception of The Patient Protection and Affordable Care Act (ACA) of 2010 (Obamacare) our health care system has been challenged with the demand to improve health care quality and patient satisfaction while reducing costs. The United States health care system is evolving from a fee-for-service to a fee-for-outcome or pay-for-performance model. Not since Medicare and Medicaid were signed into law in 1965 has there been such a significant overhaul of our health care system. In this paper, I will discuss the "pay-for-performance" strategy and how it is intended to improve the quality and efficiency of health care. Definition pay-for-performance "Pay-for-performance" is an umbrella term for initiatives aimed at improving the quality, efficiency, and overall value of health care (Robert Wood Foundation, 2012). Financial incentives are offered to hospitals, physicians, and other health care providers and facilities if certain predetermined quality or performance measures are met. The pay-for- performance model also may impose...
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...Reimbursement and Pay for Performance Kristi Thomas Health Care Organizations and Delivery Systems HCS/531 August 11, 2014 Nita Magee-Cornelius Pay for performance is a slogan that is used lightly in 2014. It seems to be a no-brainer, when we pay for services we pay for quality and not quantity. It is a bit more complex than that. The slogan actually is a reimbursement or initiative program that provides financial incentives to hospitals, physicians, and other health care providers to make improvements to and achieve optimal outcomes for their patients. The outcomes are measure and some health care providers are paid more because they are deemed to have delivered better service or their patients appear to have better outcomes. There is a controversy amongst intellectuals that ask the question “How can the quality of care be measured?” The idea behind pay for performance is simple; we will give providers more money to achieve a goal. This paper will discuss how reimbursement is affected by this pay for performance initiative, how system cost reductions can impact the quality of care, how pay for performance can affect the provider and what type of effect it will have on the future. In the following paragraphs it will be discussed whether or not reimbursement is affected, how the system costs reductions impact the quality and efficiency of health care, how pay for performance affects the health care provider and their customers and the effects that the pay for performance...
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...Pay for Performance Suley Cruz HCS/531 May 25, 2015 Sarah Dunn Pay for Performance Financing is a critical factor in health care delivery. The way health care is financed impacts it’s delivery. The continual increase of health care cost caused health care reform initiatives to control cost to focus on reimbursement models. Pay For Performance (P4P) is an increasingly popular initiative. The use of pay for performance has effects on the cost, quality, and efficiency of health care. This paper will discuss the effects the use of pay for performance has on patients, provider, and the evolution of health care delivery. Pay for Performance Pay for Performance plans were developed in the early 2000’s as a way to control costs. “Pay-for-Performance is a reimbursement plan that links payment to quality and efficiency as an incentive to improve the quality of health care and to reduce costs” (Shi & Singh, 2012, p. 586). Pay for performance is based on the belief that payment incentives will drive providers to deliver better care which will lead to disease prevention or early diagnosis. Pay for performance incentives give providers bonuses for meeting pre determined quality measures. The main quality measures used in P4P are patient experience, process, outcomes, and structure. Defining Pay for Performance Measures Patient experience refers to patients' assessment and satisfaction with the quality of care received, for example, wait time, communication and cleanliness...
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...Pay for Performance Suley Cruz HCS/531 May 25, 2015 Sarah Dunn Pay for Performance Financing is a critical factor in health care delivery. The way health care is financed impacts it’s delivery. The continual increase of health care cost caused health care reform initiatives to control cost to focus on reimbursement models. Pay For Performance (P4P) is an increasingly popular initiative. The use of pay for performance has effects on the cost, quality, and efficiency of health care. This paper will discuss the effects the use of pay for performance has on patients, provider, and the evolution of health care delivery. Pay for Performance Pay for Performance plans were developed in the early 2000’s as a way to control costs. “Pay-for-Performance is a reimbursement plan that links payment to quality and efficiency as an incentive to improve the quality of health care and to reduce costs” (Shi & Singh, 2012, p. 586). Pay for performance is based on the belief that payment incentives will drive providers to deliver better care which will lead to disease prevention or early diagnosis. Pay for performance incentives give providers bonuses for meeting pre determined quality measures. The main quality measures used in P4P are patient experience, process, outcomes, and structure. Defining Pay for Performance Measures Patient experience refers to patients' assessment and satisfaction with the quality of care received, for example, wait time, communication and cleanliness of provider’s...
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...Kudler Human Resources The success of Kudler Fine Foods is in large part to not only the quality of their products but also the quality of their employees. As part of their Human Resource operations, Kudler follows a number of standardized practices outlined in this paper to maintain excellence in each of their three stores and headquarters operations. The three areas that will be examined in detail are Policies and Procedures, the Employee Handbook and Kudler’s Human Resources Information System. Kudler Human Resources Policies and Procedures Equal to the value that Kudler Fine Foods places on customer satisfaction is that of employee satisfaction. A review of the Policies and Procedures of Kudler Fine Foods provides ample evidence that employees at all levels of the Kudler organization are valued. The simple fact that all employees in each store share in the opportunity for increased compensation based on individual store performance alone shows that the Kudler approach to making happy customers is to serve with dedicated and motivated employees. Below are the areas of interest in the Kudler Human Resource Policies and Procedures documentation. All information is from the Kudler Fine Foods – Policies & Procedures documentation (Apollo Group, Inc., 2006 c). • Recruitment o Entry level positions are generally hired from outside of the existing employee pool. o Methods of Recruitment: In store and existing employees, employee...
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...Motivational and sales performance reports On Glaxo Smith line India Limited Mumbai- India Contents Introduction 3 Company background 4 Literature Review 5 Intrinsic Rewards 5 Extrinsic rewards 6 Hygiene factors 7 Current issues, solution Proposal and conclusion 10 Stability 10 Hidden policies 10 Security 11 Politics in pay increment and promotion 11 Delay in reimbursements of incentive and awards 12 Unhealthy competition 12 Expectancy and valance of awards 13 References 14 Appendices 16 Appendix -1 16 Appendix-2 18 Appendix-3 20 Introduction Modern organisation faces a lot of challenges in retaining and motivating the staff as human resources are vital part of any organisation. These challenges like recruiting developing and retaining sales staff must be taken care off to gain maximum outcome from employees. To retain the employee, company uses different motivational techniques. This report is provided to determine the importance of motivational techniques for retaining staff motivated. Based on literature and journal article, motivational factors are discussed in this report. And how these motivational factors motivate the employees in selected organisation i.e. Glaxo Smith line India Limited. Different Motivational theories are discussed here to help the organisation to develop and retain the sales force and also discussed the issues and risk of the same followed by proposed solution is also provided here (Ali & Danish...
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...Research Process The ultimate goal of the student data collection is to determine the average monetary expense of furthering one’s education for one calendar year. The subjects of this paper are students of the University of Phoenix’s Bucks County Campus. The cost of obtaining a higher education at this university is approximated by using a focus group, consisting of four learning team members. Constructs, such as tuition cost, travel expense and resource expense data from each subject will be explored. In order to effectively measure the information obtained from the focus group, controls are implemented on the data. This study assumes that each student travels to and from the campus twice a week. The first trip is made to attend class and the second trip is made so that each student can participate in a physical learning team meeting. Since the duration of each class is five weeks in length, the analysis used is based on 10 trips to the University of Phoenix campus. Each student will complete 10 courses per calendar year. The distance involved in traveling to the campus will be measured by mileage, price of gasoline, and tolls. Another measurement is tuition cost per course. The constructs for the tuition cost include tuition reimbursement and out-of-pocket expense. Travel expenses were calculated based on current gasoline average cost of $2.69 per gallon. Mileages per gallon calculations were based on 17 miles per gallon of gasoline from participant’s home to the...
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...Pay Performance and strategies to encourage adoption of EMR ? Pay for performance in healthcare provides financial incentives for healthcare workers like clinician for better healthcare outcomes. These outcomes are longer for survival, are very difficult to quantified and measure, so pay for performance systems usually are method used to measure the outcomes process, for example measuring blood pressure or counselling for patient to quits smoking. According to Mr. Aaron E. Carroll, a pediatric professor who write for the New York Tines, tell after reviewing the medical literature in year 2014 that pay for the performance in US and UK has created a disappointing mixed results. Sometimes even though large incentives it will not change the way doctor practice medicine. Critics say that pay for performance is a method borrowed from the corporate management which the main results or outcomes is for profit. In the practice of healthcare and medicine, many important outcomes and aspects such as spending time with the patient, can’t be quantified measured. Pay for performance is also known P4P’s or value based purchasing this payment method rewards the doctors, nurses, and other healthcare staffs for meeting a certain criterion for quality and efficiency. It penalized staffs or caregivers for poor outcomes, medical errors, and increases cost. Electronic Medical Record (EMR) and pay performance are one of the methods for health reformers to use for improving patient care. It is...
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...importantly my future job whatever that may be. My current job is very informal and does not require me to write very often. Once I graduate college I plan to leave this position behind and move forward in the banking industry which I know will be much more professional. It is there where I really plan to utilize these skills, whether I will be writing internal memos, corresponding with clients, preparing a report for my superior, or writing e-mails. I think one of the most important lessons I learned in taking this class was the difference between academic writing and business writing. Especially since I am currently a student it can be difficult to make that transition. Writing papers for class I am used to trying to impress my instructor with an extensive vocabulary and using a lot of “fluff” to make my papers flow and to meet certain word requirements. Where in business writing I do not want my audience to need a dictionary to translate what I am saying, most people are busy and will probably be juggling several tasks while trying to read the document. It needs to be quick and to the point delivering only necessary information. This is a class that I think everyone is able to benefit from regardless of what their major is. I know that I have learned some valuable lessons over the past several weeks that could put me a step ahead my co-workers. Checkpoint – Business Writing Graphic Organizer Sharon Tucci XCOM/285 August 31, 2012 Karen Blatter-Schieler Planning Analyzing ...
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...Procurement Law Overview, Part One Procurement and Contract Law Procurement Law Overview, Part One The purpose of this paper is to provide an overview of procurement law. There are three different branches of Government: Legislative, Executive, and Judicial. In the United States, the Office of Federal Procurement Policy (OFPP), the Defense Acquisitions Regulations (DAR) Council, and the Civilian Agency Acquisition (CAA) Council determine federal procurement policies by its legislative action and recommendations. Those are then published in the Federal Acquisition Regulation (FAR). The FAR is issued jointly by the Department of Defense (DOD), the General Services Administration (GSA) and the National Aeronautics and Space Administration (NASA). It applies not only to direct purchases made by the government, but also to purchases made by federal grant recipients (Feldman, 2010). The government procurement team is made up of the Contracting Officer (CO), Administrative Contracting Officer (ACO), and Termination Contracting Officer (TCO). The government planning process consists of market research and an internal source search before they proceed with full and open competition which allows all responsible sources to submit either a sealed bid or competitive proposal on the procurement. The market research consists of availability and quantities of items, and reasonable prices. Internal sources include existing inventory, excess from other agencies, and federal prisons (Feldman...
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...regulatory agencies, among others. To enhance patient-centered care, business practices, regulatory requirements, and reimbursement regulatory procedures have been adopted. This is evident by the regulations of Joint Commission and the provision of services by Medicare Medicaid services (CMS). In this paper, the impact of business practices, regulatory requirements, and reimbursement procedures on patient-centered care is discussed. A multidisciplinary approach on a process improvement enhancing Patient and Family Centered Focus Care is outlined in a hospital located in Arizona. Regulatory Requirements and Healthcare Business In 1996 the Institute of Medicine took on healthcare improvement to resolve unsafe care by ambitiously moving toward quality initiatives. The release of “To Err Is Human: Building a Safer Health System19 (1999) and Crossing the Quality Chasm (2001)” focused on the fails of the healthcare systems pointing out that over 98,000 patients die in hospitals annual due to some sort of medical error (Roussell, 2011). This report was the source of the new transformation of healthcare delivery brigding gaps from a state of broken system to an ideal state of evidence based care. Consumers are well aware of the possibilities of hospital errors and quality care and have become aware of number of business case practices, regulations, and reimbursement...
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...policies: This document is posted in the Course Materials forum. University policies are subject to change. Be sure to read the policies at the beginning of each class. Policies may be slightly different depending on the modality in which you attend class. If you have recently changed modalities, read the policies governing your current class modality. Course Materials Shi, L., & Singh, D. A. (2012). Delivering health care in America: A systems approach (5th ed.). Boston, MA: Jones and Bartlett. All electronic materials are available on the student website. Assignment Breakdown Week One Individual Assignment: Significant Health Care Event Paper 10 Week Two Learning Team Assignment: The Evolution of Health Care Paper and Timeline 10 Week Three Individual Assignment: Technology and Health Care Paper 12 Learning Team Assignment: Evolution of Health Care Systems – Annotated Bibliography 5 Week Four Individual Assignment: Health Care Careers Diagram and Summary 10 Learning Team Assignment: Evolution of Health Care Systems Presentation Outline 3 Week Five...
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...Human Resource Final BUS3040 Capella University March 11, 2014 Introduction This paper will provide information and/or recommendations on how to improve the human resource functions of Assurant. The areas of recruiting, development, training, and employee discipline. These areas are essential to running the human resource department and ensuring that all employees are ready and prepared to begin their career journey with Assurant. This paper will also address compensation, benefits and labor relations. Recruiting and Selection: At Assurant Talent Acquisition manages recruiting activity through an applicant tracking system, Taleo. As a manager, when there are open positions, a requisition is created for that position using Taleo's Recruiting Center for Managers. Potential candidates will then work with the Talent Acquisition team to follow the standard Assurant Hiring process to find the best qualified candidate for your position. The standard hiring process for Assurant is to provide telephone interview to get a feel for how the candidate will conduct themselves over the phone, and access the skill level they are on. If the candidate passes they are then sent to have a panel style interview with one of the teams , once the candidate has gone through the interview process , they are then subject to drug testing before any offers are made. Recommendations to make the process a little more seamless, the suggestion should be made to the hiring managers to streamline...
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