Benefits Of The Next Payment Model

Four compensation models are laid out by the Bangor Family Physician case study. These models include: (1) revenue model; (2) net income model; (3) base salary plus

Financial Incentives for Primary care: Comparison costs of practices using PCMH model to those that do not and achieved savings (by reducing hospital admissions and unnecessary tests, they can get half $ back. The catch is that they only get the $ if they’ve met a whole checklist of quality measures for preventive care, chronic disease management and so on. Primary Care is rewarded for efficiency without sacrificing quality. Half of savings goes to Geisinger’s own health plan that funds extra services and creates medical homes. The health plan earned 2.5 times its R.O.I. back in the first year.

According to the Centers form Medicare & Medicaid Services a Prospective Payment System (PPS) is a "method of reimbursement in which Medicare payment is based on a predetermined, fixed amount." There are different amounts for the different types of care settings including: home health agencies, hospice, acute inpatient hospitals, inpatient psychiatric facilities, skilled nursing facilities, long-term care hospitals, and inpatient rehabilitation facilities. The two facility types I chose to look at are home health agencies and skilled nursing facilities. For home health the PPS payment is based on a 60 day episode of care. The agency gets half of this payment when the claim is filed and half at the end of the 60 day period. At a skilled

In 2012, the ACA found an excessive amount of readmissions of patients that were hospitalized within 30 days for the same medical conditions. This factor viewed under the ACA as a quality issue and CMS implemented value-based incentive payments based on performance in a set of quality measures. The plan is to implement a pay for performance (P4P) in formulas used by Medicare to reimbursement providers. “The objective is to link reimbursement to quality and efficiency as an incentive to improve the quality of health care, as well as reduce system-wide costs” (Shi and Singh, 2015). In addition to the P4P, nonprofit hospitals also focus on continual improvement, data and cost containment throughout the organization (Adamopoulos,

The goal of the initiative is to increase efficiency of care, improve quality of care, and lower costs. This initiative consists of four different bundled payment models. The first three bundled payment models are retrospective payment arrangements based on patients’ historical data. However, the fourth model is proposed for the future. Centers for Medicare & Medicaid Services (CMS) make a single bundled payment to the hospital for all services during inpatient stays for hospitals, physicians, and other medical professional specialists.

It is commonly believed that the method of physician remunerations affects their professional behavior. As a result, payment systems are therefore manipulated in attempts to achieve policy objectives with the primary aim to improve quality of care, contain cost and maintain recruitment of human resources in underserved areas. (2,1)

There is a growing trend in the United States called pay-for-performance. Pay-for-performance is a system that is used where providers are compensated by payers for meeting certain pre-established measures for quality and efficiency (What is Pay-for-Performance, n.a.). We are going to be discussing what pay-for-performance is. There are different aspects of pay-for-performance which include; the effects of reimbursement by this approach, the impact cost reductions has on quality and efficiency of health care, the affects to the providers and patients, and the effects on the future of health care.

In the book “Street Sex Work and Canadian Cities: Resisting a Dangerous Order” by Shawna Ferris, she discusses the influence of mainstream media representation of street workers on the ever-grown urbanized population. Across the country, media sources promote an anti-prostitution bias and incorporate images and stories that portray sex workers as a nuisance to society. A study was that was conducted by Erin Gibbs Van Brunschot, Rosalind A. Sydie, and Catherine Krull, in regards to media related-news on prostitutes between 1981 and 1995 in Canadian newspapers discovered that their themes were all inter-connected. “There were four themes that were most prevalent in the years under review: nuisance, child-abuse, violence, and non-Western prostitution.”

I am David Alan Moore, I am Irene’s oldest son. I met Roger in 1988. I’ve noticed Roger’s heavy drinking habits, and his apparent issues with control. I’ve been a witness to emotional and physical abuse.

Pay-for-performance payment model – healthcare payment systems that offer financial rewards to providers who achieve, improve or excel their performance on specified quality of care and cost measures (HealthCare Incentives Improvement Institute, N.D.)

First implemented in 1985 by Aetna (previously U.S. Healthcare), P4P programs were used to reward top performers and improve outcomes (Bruno, 2012). The incentives were meant to improve the quality of patient care by basing incentives on patient outcomes. Conversely, fee-for-service reimbursements are based on the treatments and set limits on the amount reimbursed for services. Because of these limits, incentives for use of pharmaceuticals and non-invasive procedures can impact how physicians practice.

The service-based pay structure provides significant motivation for healthcare providers to deliver as many services as possible, with little to no consideration of patient outcomes. Furthermore, this structure provides no incentive for certain key elements of healthcare such as patient education and care coordination, both of which have led to diminished costs and better outcomes for patients. I am of the opinion that very little quality improvement will take place if this pay-for-service model persists. The current transition from service-based pay to quality-based pay is definitely a move in the right

One of the wonderful things about the book of Acts is the way that it displays the gospel in action. In this book, one can read about many different individuals that were convicted by the gospel, such as the 3,000 on Pentecost (Acts 2:41), the 5,000 in Acts 4:4, Simon the ex-sorcerer (Acts 8:9-13), the Ethiopian man (Acts 8:26-39), Saul (Acts 9:1-19), Cornelius and his household (Acts 10:44-48), and many, many others! However, the book of Acts also recounts individuals who made the unfortunate and dreadful mistake of rejecting the gospel. Consider the account of Felix, a Roman governor. After Paul made his defense before Felix while on trial (Acts 24:10-21), Felix called for Paul to come to him and further explain Christianity (Acts 24:24).

A principal-agent relationship arises whenever the principal contracts the agent to perform services or supply goods. As set out in the contract, the agent needs to put efforts to produce the output required by the principal, for which the principal pays the agent rewards contingent on particular circumstances occurring. The physician-patient relationship is always modelled within the theory of agency, with consideration of the associated incentive problems. In particular, a physician's is characterized by multiple tasks and multiple principals. Therefore, some dimensions might be difficult to measure and monitor within a classical agency theory. For example, after the physician putting his effort in the first period, it is difficult to measure the amount of effort he will put in the future. Although it might be able to determine whether or not a operation is successful right after the surgery ends and therefore to measure how much effort the physician puts, it is difficult to predict the quality of post-operative care. In this case, the informal payment contributes to ensure physician's follow-up effort.

Under payment, an ideal healthcare system will have the challenge of delivering higher quality for lower costs. The system’s payment reform will involve a transition from fee-for-service to global from systems that are value-based important for the achievement of the overall healthcare goals. An ideal healthcare payment system will give a great deal of support to value-driven system of healthcare delivery (Kent, 2013). The fee-for-service payment system will be of great importance to the healthcare system as it will help control the costs of health care.