Value based purchasing is a payment model that offers financial

 

Value based purchasing is a payment model that offers financial incentives to healthcare providers and organizations when they meet certain performance measures. This model also penalizes healthcare providers for poor outcomes, medical errors, or increased costs. Managed Care Organizations (MCOs), Accountable Care Organizations (ACOs), and Bundled Payment Care Improvement (BPCI Advanced) are prospective value-based purchasing programs aimed at improving healthcare quality and reducing costs. Hospitals and physicians participate in these programs with the goal of getting the right care to the right patient at the right time.

In this Discussion, you will consider what happens with these systems as they relate to nursing home care. Nursing home administrators are facing a reduction in the demand for skilled nursing rehabilitation (SNF) beds, while physicians in an ACO or a gain-sharer in a BPCI program are looking at discharging patients with home care or outpatient resources to reduce cost. All these programs are affected by re-admission penalties.

Most businesses are constantly looking to reduce cost. In healthcare, often the necessity to reduce cost means a reduction in utilization. Consider how this compares to a retail market where reduced demand reduces cost by consumer choice. How much influence does the consumer have on the change in healthcare economics? Is it the payer (Medicare), the provider (the physician), or the patient?

Consider the following scenarios:

Scenario 1: You are a rehabilitation director in a nursing home. Your administrator has given you the directive that, to participate with a Medicare MCO and become a preferred provider for a hospital BPCI or comprehensive care for joint replacement (CJR) program, you need to reduce the length of stay for the short-term rehab patients from 20 days to 10 days for DRG 470: Total knee replacement. To compound the problem, you see that the usual 400 total knee patients you get annually has been reduced to 160 patients.

Scenario 2: You are the manager of a large orthopedic practice who participates in the BPCI program. Your practice does 400 total knee patients each year. Medicare has set pricing for a Total Knee Replacement patient at $28,415 per patient for a 90-day episode of care. Current practice is that all patients automatically go to a skilled nursing facility (SNF) for 20 days. Based on current research the goal is for 60% of your patients to go home with home care and those going to a SNF to stay for 10 days so the BPCI program will be profitable.

To Prepare:

  • Review the Learning Resources for this week.
  • Select one of the two scenarios to focus on for this Discussion.
  • Reflect on the scenario, and consider redesign measures you might recommend. For example, consider length of stay, reducing readmissions, attracting new business, care redesign, patient satisfaction, and physician engagement.  

By Day 4

Post a comprehensive response to the following:

  • Describe at least three care redesign strategies you might recommend to the scenario.
  • Justify why you selected these three care redesign strategies and explain how you would implement the redesign strategies you recommended.
  • Be specific, and provide examples.
  • Be sure to support your Discussion with a reference to course materials or a reference within the last three years.
University Writings
Calculate your paper price
Pages (550 words)
Approximate price: -

Why Work with Us

Top Quality and Well-Researched Papers

We always make sure that writers follow all your instructions precisely. You can choose your academic level: high school, college/university or professional, and we will assign a writer who has a respective degree.

Professional and Experienced Academic Writers

We have a team of professional writers with experience in academic and business writing. Many are native speakers and able to perform any task for which you need help.

Free Unlimited Revisions

If you think we missed something, send your order for a free revision. You have 10 days to submit the order for review after you have received the final document. You can do this yourself after logging into your personal account or by contacting our support.

Prompt Delivery and 100% Money-Back-Guarantee

All papers are always delivered on time. In case we need more time to master your paper, we may contact you regarding the deadline extension. In case you cannot provide us with more time, a 100% refund is guaranteed.

Original & Confidential

We use several writing tools checks to ensure that all documents you receive are free from plagiarism. Our editors carefully review all quotations in the text. We also promise maximum confidentiality in all of our services.

24/7 Customer Support

Our support agents are available 24 hours a day 7 days a week and committed to providing you with the best customer experience. Get in touch whenever you need any assistance.

Try it now!

Calculate the price of your order

Total price:
$0.00

How it works?

Follow these simple steps to get your paper done

Place your order

Fill in the order form and provide all details of your assignment.

Proceed with the payment

Choose the payment system that suits you most.

Receive the final file

Once your paper is ready, we will email it to you.

Our Services

No need to work on your paper at night. Sleep tight, we will cover your back. We offer all kinds of writing services.

Essays

Essay Writing Service

No matter what kind of academic paper you need and how urgent you need it, you are welcome to choose your academic level and the type of your paper at an affordable price. We take care of all your paper needs and give a 24/7 customer care support system.

Admissions

Admission Essays & Business Writing Help

An admission essay is an essay or other written statement by a candidate, often a potential student enrolling in a college, university, or graduate school. You can be rest assurred that through our service we will write the best admission essay for you.

Reviews

Editing Support

Our academic writers and editors make the necessary changes to your paper so that it is polished. We also format your document by correctly quoting the sources and creating reference lists in the formats APA, Harvard, MLA, Chicago / Turabian.

Reviews

Revision Support

If you think your paper could be improved, you can request a review. In this case, your paper will be checked by the writer or assigned to an editor. You can use this option as many times as you see fit. This is free because we want you to be completely satisfied with the service offered.