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Value-based reimbursement models are becoming more common in healthcare. Value-based models structure reimbursements according to metrics like efficiency, cost, quality, and patient feedback (Pennic, 2014). Some of the most commonly used value-based reimbursement and payment models include Medicare Quality Incentive Programs, Pay for Performance, Accountable Care Organizations, Bundled Payments, Patient-Centered Medical Home, and Payment for Coordination (Pennic, 2014). More traditional reimbursement models include standard fee-for-service systems, which are woefully inefficient for patients with chronic conditions due to the large number and type of treatments needed (Sanghavi, George, Samuels, et al, 2014). While there is no one preferred approach to reimbursements, value-based models are clearly superior to fee-for-service models.One of the most promising value-based reimbursement models is the Patient-Centered Medical Home model. This model tends to be more culturally-appropriate than others, taking into account individual and family needs, community diversity, and other contextual variables that might impact patient health outcomes (Pennic, 2014). Like other value-based reimbursement methods, the Patient-Centered Medical Home relies on a team-based, collaborative decision-making process. Therefore, it does require collaboration and communication between healthcare workers assigned to each patient. The potential drawbacks...
Moreover, the Patient-Centered Medical Home model allows for the introduction of holistic care and regular checkups that promote preventative care.
Another patient-centric model that is useful for some, but not all, cases is the bundled payment or episode of care model. More useful for patients with one-time needs, the bundled care model covers all procedures for a specific condition under one rubric. There are clear benefits for bundled care for one-off surgeries like hip replacements or cataract surgery, heart surgery, or for pregnancy and childbirth (Valence Health, n.d.). However, cost accounting can become complicated when ancillary services are needed or when complications arise. The bundled care model also does not meet long-term needs and does not cover preventative care. Yet some patients may prefer the bundled care option when they are generally healthy and prefer not to access the healthcare system throughout their lives. The Patient-Centered Medical Home model, on the other hand, does require active patient participation in healthcare.
The Patient-Centered Medical Home model shares much in common with the Accountable…
Health Care Economics In economics, cost-benefit analysis assists in evaluating the costs of an approach in terms of resources spent while cost-effective analysis evaluates the costs as achieving some sort of benefit which is not evaluated in monetary terms. Moreover, cost-benefit study examines several aspects including net-present value, present value of benefit, and present value of costs; in line with this, if a project indicates that the monetary outcome is greater
Healthcare Fraud Identity theft and fraud of many types and forms are obviously a major inconvenience and hindrance to anyone that falls prey to a person that engages that crime. There are many variants and forms of fraud and identity theft out there. One of the more insidious and nasty examples of those crimes would be that which relates to healthcare. Indeed, to have people's wallet, healthcare and the taxpayer dollar
Health Care in the U.S. And Spain What Can the U.S. Learn About Health Care from Spain? In 2009, Spain's single-payer health care system was ranked the seventh best in the world by the World Health Organization (Socolovsky, 2009). By comparison, the U.S. health care system ranted at 37 (Satiroglou, 2009). The Spanish system offers coverage as a right of citizenship that is constitutionally guaranteed. Spanish residents pay no expenses out-of-pocket, with
097 United States 0.109 0.093808 0.036112 0.068 Utah 0.1071 0.1401 0.035696 0.073 Vermont 0.1326 0.0988 0.040851 0.114 Virgin Islands NA NA NA Virginia 0.1048 0.0829 0.080009 0.092 Washington 0.1229 0.0669 0.027831 0.068 West Virginia 0.1293 0.0774 0.036499 0.055 Wisconsin 0.0954 0.0357 0.032367 0.097 Wyoming 0.1251 0.1453 0.053867 0.075 Notes All spending includes state and federal expenditures. Growth figures reflect increases in benefit payments and disproportionate share hospital payments; growth figures do not include administrative costs, accounting adjustments, or costs for the U.S. Territories. Definitions Federal Fiscal Year: Unless otherwise noted, years preceded by "FY" on statehealthfacts.org refer to the Federal Fiscal Year, which runs from October 1 through September 30. for example, FY 2009 refers to the period
Transparency empowers consumers to become better shoppers. Economists assert that transparency stimulates productivity, for example, in exchange for money, one individual obtaining fair value. In every aspect, except healthcare, Davis points out, transparency, is supported. The contemporary dearth of transparency in healthcare has led to many Americans not being able to effectively shop for the best quality of service at acute care hospitals. Davis argues that transparency permits consumers,
(Worcestershire Diabetes: a New model of care Stakeholder event, 2007) The continuum of care for the diabetic patient is shown in the following illustration labeled Figure 1. Diabetes: Continuum of Care Source: Worcestershire Diabetes: a New model of care Stakeholder event (2007) The continuum of care for diabetes begins at the moment that the individual is found to have diabetes and continues across the individual's health care providers and across the varying stages