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1Payment Systems andReimbursement Method AnalysisCarrie FerrellSouthern New Hampshire UniversityIHP 630: Healthcare Finance & ReimbursementDr. ArsenaultAugust 23, 2020
2AbstractThis paper is a report to management researching various methods of reimbursement to prepare strategies and implement internal recommendations that will maximize reimbursement. This report will review government compliance, reimbursement strategies andguidelines as well as analyze errors to determine quality benchmarking errors to put into play to reduce these errors. This report will assess financial management principles to guide strategic planning for the organization. This report will analyze federal, state, and third-party payer regulations and reporting guidelines to ensure the organizations compliance. Teamwork principles will be suggested to improve collaboration and planning processes. Financial approaches for improving cash flow, days spent in accounts receivable, and reimbursement timeliness will be discussed. Finally this report will end with recommending strategies for maximizing healthcare reimbursement by reviewing case rate and utilization management impact on pay-for-performance incentives. Keywords: Healthcare Administration, Healthcare Finance, Healthcare Reimbursement, Reimbursement Strategies, Pay for Performance, Benchmarking, Accounts Receivable, Operational Planning, Strategic Planning
3Payment Systems and Reimbursement Method AnalysisWhat is the purpose, scope, and subject of your analysis and management report? Your introduction must describe the aim of your paper, what you are assessing, and the analysis you expect to perform. The introduction is the first paragraph of the body of your paper and is a summary of the topic, which is health care reimbursement. It should be something broad such as "Health care reimbursement in the United States is a complex system of governmental and private payers and regulatory requirements. The system is complicated by the fact that not all in our country have insurance coverage and have limited coverage, leaving many with high out-of-pocket financial obligations. This paper will analyze payment systems and reimbursement methods and regulations and reporting requirements, including compliance considerations. The paper will also review the importance of the revenue cycle process and the need for team work in health care organization and make operational recommendations to management for improvement. " etc. etc. Just one short paragraph is fineFinancial Principles and ReimbursementReimbursement StrategiesPay-for-performance is “any type of payment arrangement to reimburse providers that is performance-based and that includes incentives”.[ CITATION Cas18 \l 1033 ]This strategy represents a widespread shift by the healthcare industry to improve quality, efficiency, safety, andthe overall value of healthcare. This shift was put into place due to rising costs within healthcare.