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FINANCIAL PRINCIPLES AND REIMBURSEMENT1Financial Principles and ReimbursementAshlee ThompsonJanuary 9, 2018
FINANCIAL PRINCIPLES AND REIMBURSEMENT2While working as an administrator in healthcare, it is important to know how to utilize the revenue cycle management program and ensure the organization is thriving. The job duties include the organization is making sure the organization’s costs stay low and have a flow of reimbursement coming in. Compliance issues must be met. Promoting cooperation between each department is crucial just as it is making sure each of them is up-to-date about trends in technology and educating them on how to stay informed on the changes in market of payer trends, government, and regulatory modifications [ CITATION Cas13 \l 1033 ]. The overall goal is to make sure patient care and readmissions were as low as possible. Offering the patient a lower-cost option for follow-up care can help maintain loyal clientele. Reimbursement Strategies: What is the impact of case rates and management utilization data on pay-for-performance incentives? Be sure to provide support for your response.The Patient Protection and Affordable Care Act (PPACA) was the new law in 2010 that gave the Administration widespread authority to control every aspect of health care finance and to impose its view of how the health care system should operate [ CITATION Hof10 \l 1033 ]. The reimbursement strategy in healthcare is a common technique that allows employers to provide their employees with more choices about healthcare expenditure. The PPACA, also known as Obamacare, creates new Medicare programs intended to improve health care quality using “pay-for-performance” payment strategies to put financial pressure on medical providers. The reimbursement reflects provider performance on metrics based on adherence to certain care processes, scores on patient satisfaction surveys, and patient outcomes. The rationale behind the pay for performance is that the payment for medical services does not reflect the benefit for patients or value [ CITATION Hof10 \l 1033 ].
FINANCIAL PRINCIPLES AND REIMBURSEMENT3b) Reimbursement Methods: Analyze reimbursement methods, describing the advantages and disadvantages of each method in terms of strategic planning for operational performance. For example, why might one method be more advantageous than another at ahospital or at a physician’s office?