Questions On Practice Management Assignment Essay

1. In order to implement an organizations commitment to social responsibility it is necessary to identify what social problem the organization intends to address, develop policies on what the organization plans to do to successfully fulfill its obligation and ensure stakeholder buy-in. The main obstacles an organization faces when implementing socially responsible policies is pressure from stockholders and business analysis who want steady increase in earnings. Without steady increase in profits, it becomes difficult to reinvest money in these areas. The following actions can be taken toward increased social responsibility:

To organize and prioritize the current and future projects in the pipeline in a way that fits into the PMB budget of $5B, and ensures projects that increase sales, growth, and stockholder value are of top priority, whereas projects that are not beneficial are either put on hold or discarded.

Like what was stated previously, the cost of having Nurse Practitioners in place of doctors is lower. This is because their salaries are much less and the cost structure is lower. Evidence of this can be seen with Medicare and Medicaid. These government sponsored programs will pay for 85% of these services in comparison with doctors. This is important, because it is showing how the lower cost structure is one reason why Nurse Practitioners are playing a major role inside a health care environment. (Pickert, 2009)

The financial department have been asked to carry out analysis all invoices from the past year to provide data on where wastage is taking place.

In a health maintenance organization, a contract is made between enrollees and a panel of providers. The enrollees use the method of capitation for payment, meaning they pay a predetermined fixed fee monthly for a period of one to three years regardless of how many times they use their medical service or of how much it costs each time (Chitty & Black, 2007). In a preferred provider organization the a contract is made between the client and a group of independent doctors that team with hospitals to provide cheaper health services for their patients (Chitty & Black, 2007). They are able to provide some of the lowest fees because they have such high volumes of patients to make up for the discounted price (Huntington, Glossary For Managed Care, 1997).

Within this assignment I will describe my understanding of the links between management and leadership, the skills and styles of management and leadership, the application of management and leadership theories in an organisational context and planning for the development of management and leadership skills.

Reimbursement for the advanced practice nurse (APN) is improving but how they fit into reimbursement systems is vey important. One question that arises is if the APN should be paid the same fee for service as a physician or should only a percentage of the payment be received. Most third-party reimburses, which include a few large insurance companies are now reimbursing APNs and more states are getting on board with reimbursements by developing reimbursement models for APNs (Hamric, 2009). For example, Aetna US Healthcare, Anthem Blue Cross and Blue Shield of Kentucky, Medicare and Medicate all credential NPs as primary care providers and pay at 85% of the physician rate. Tricare of Kentucky credentials NPs and pays 100%.

My organisation’s mission is to provide an efficient and helpful service to all our customers so that our client base grows.

There are important advantages to capitation which should be addressed as well as the disadvantages. MCO’s have to negotiate and contract with physicians carefully and strategically. As stated in the Module 3 PowerPoint lecture notes, a number of factors will determine which reimbursement approach is used such as amount of care competition and density of PCP’s in a given geographic area, (Orji, 2015, PowerPoint slide 10). Depending on the plan, the physician gets paid and costs do fluctuate from different regions. Beneficial ways of capitation which are they have an arrangement when specific services that

Capitation is a flat rate payment for each member enrolled with a healthcare provider; i.e. it is the sole reimbursement system for services provided to a specifically defined population (Lee, 2012). These payments are expressed as a dollar amount, per member per month (PMPM), the term member referring to enrollee’s in a managed care plan. These plans are usually termed Health Maintenance Organization (HMO). An example would be a doctor receives a capitation payment of $25 PMPM, for providing for the care needs of 250 members of the regional HMO. This part of a calculated fee for a yearly contract payment based on the number of members and must cover all primary services offered to the patient population specific to the HMO. These payment amounts can be adjusted for age and gender only.

According to wikipedia Capitation is a payment arrangement for health care service providers such as physicians or nurse practitioners. It pays a physician or group of physicians a set amount for each enrolled person assigned to them, per period of time, whether or not that person seeks care. Capitation payments are used by managed care organizations to control health care costs. Capitation payments control use of health care resources by putting the physician at financial risk for services provided to patients. At the same time, in order to ensure that patients do not receive suboptimal care through under-utilization of health care services, managed care organizations measure rates of resource utilization in physician practices.

Management is a “process, comprised of social and technical functions and activities, occurring within organizations for the purpose of accomplishing predetermined objectives through human and other resources.” In order to achieve the desired objectives of the organization, managers carry out technical and interpersonal activities and work through and with other people. PPG 4. This paper will summarize my interview with such manager, along with the description of the purpose of interview, brief introduction of the interviewee and his organization. The paper will also relate ideas and topics covered in the interview with the management principles in healthcare and finally explain what was learnt in this process.

According to Gapenski and Pink (2015), “Under capitation, providers receive a fixed fee for each patient enrolled in the capitated plan” (p. 87). As stated above, capitation creates a significant incentive for providers to control the cost of delivering health services, by being paid a fixed amount for each patient enrolled, providers are motivated to control the number of services provided. On the other hand, under capitation, if providers do not control the cost of delivering health services, the cost per member enrolled will exceed the fixed payment. In addition, since the control of the net profit obtained

Under capitation, physicians are given incentive to consider the cost of treatment. Pure capitation pays a set fee per patient, regardless of their degree of infirmity, and gives physicians an incentive to avoid the most costly patients (Miller, 2009). Providers who work under such plans focus on preventive health care, as there is greater financial reward in prevention of illness than in treatment of the ill. Such plans avert providers from the use of expensive treatment options. The proponents of this method of payment especially insurance companies argue that when health care providers are not paid extra for additional office visits any associated medical expenses, they are likely to be more conservative with their treatment assessments

The company that is listed as number one on the Fortune 500 list is Wal-Mart. This company has much strength that makes it very interesting for investment. Wal-Mart was founded by Sam Walton in the 1950’s and faced competition among many regional discount stores. In 1962 Wal-Mart officially began with its first store in Rogers, Arkansas. Wal-Mart now has over 600 discount stores in the United States and stores located in 28 countries. No matter the size of the company its purpose has not changed over the years. Mr. Sam Walton said, “If we work together, we’ll lower the cost of living for everyone... we’ll give the world an opportunity to see what it’s like to save and have a better