Tuesday, January 29, 2019
Reimbursement and Pay for Service Essay
IntroductionIn this paper we  bequeath discuss what pay for  murder is and explain what the reimbursement  appropriate is. In this paper it will show how the system figures out  represent reduction and the impact of the  prize c be pa linents receive.How does reimbursement and pay for  exertion  repair the physicians? Does this affect us now and will it in the future? wellness  shell out has been changing dramatic solelyy because of history, political and social along with  scotch reasons. Reimbursement and pay for  movement can and may even change the quality of cargon. Pay-for- accomplishment because our current payment system we  be using is  non  emphasize  safety  make do for  forbearings or consumers. Pay-for-Performance is payment used in the   wellness care it is and has been  base off of clinical information. The idea is to help tie the payment to what and how well  suppliers help the  terms of  health care drop. The  design is for preventive care medicine to helping decreas   e and help with the  centering of chronic illness. (Pay-for-Performance Incentive Programs in Health Care ( N.D.) With in  some(prenominal) months studies have shown that the studies show that the pay for performance works and others that say it does not work. Effect of Pay-for-Performance on ReimbursementHere are some examples of pay for performance is Bridges of Excellent, which is a nonprofit health care  invent. Its major  figure is  patients with diabetes. They feel like oer 60% of patients with diabetes dont  trounce the proper treatment and care. The American Diabetes Association has standards and the Bridges to excellent  pattern gives annual bonuses to physicians in specific areas such as Boston, Louisville and Cincinnati these cities could and have  obtain the requirements of this health care  fancy. On this  plan Diabetic care calls for the patient being compliant with care and medications. In this plan the blood  simoleons test and kidney function and retinal exams would    have to be through on a consistent bases. In this plan compensation is up to and over $100.00 per patient for the providers that stick to the rules.Another plan is Anthem Indianapolis this plan started in 1999 that employed over 25 OBGYN providers in Ohio. This is the oldest plan  in spite of appearance the US. This plan is done on and by patient satisfaction. Providers push  generic wine drugs instead of name brand ones. Pay For PerformancePay for performance is a movement in health care field.Providers under this  musical arrangement are rewarded for meeting pre-established target dates for specific health care  work or procedures. This is also known as P4P or value-based purchasing, this rewards physicians, clinics, and rehabilitation centers,  working(a) clinics, hospitals, medical groups, and other healthcare providers. They are rewarded for meeting certain performance measures, as well as quality and efficiency. (Wachter, Bob (2012) Pay for performance does things such as    eliminating payments for negative consequences of care. Which can be medical errors from all health care providers. Errors have increased  comprises. With increase of seasoned  aged(a) citizens and disability patients the high rising  make up of health care has brought the P4P to the strawman of the line. Brought P4P to the forefront of health policy discussions. There have been some studies done by several large healthcare systems. With this it has shown improvements with specific outcomes. A  fiddling efficiency has taken  perfume, but at no cost savings. How  overmuch are they really saving because the cost of administrative divine services is  unflustered required. Explains how reimbursement is affected by the pay-for- performance approach.Within the last decade or years the economy has had many people becomingunemployed and decision jobs at a  frown pay rate as to where they cannot  put up with insurance because they are to high. With being done more people are applying for Me   dicaid and with all the seasoned senior citizens retiring and receiving Medicare these two insurances are already participating in this service. Majority of health care systems are participating.  many another(prenominal) believe that for- profit and non-for-profit health care facilities believe in lower cost for providers that meet the standards of quality care.Care field. There is a  wisdom that cost is driving up health care treatment. Cost reductions lowers cost of visits, emergence room visits, and urgent care visits. It also helps providers to promote preventive care to their patients. Making sure that all hospitals and providers are on the  identical scale of service. Preventive care helps prevent insurance premiums from rising at cost to the company and consumer.Effect of Pay-for-Performance health care Providers and their PatientsThis plan has the  relief of providers, hospitals and even patients. With this pay for providers must have and use good  sentiment for treatme   nt and medication and test that maybe ran. The health care cannot be rated by race, ethnic background, or the patients social status. This plan should not judge by a patients location. This plan is and should be a relationship between patient and provider. The provider  require to understand the patients beliefs and it may help them to treat them and respond to certain myths and recommendations that the provider may suggest.Hospitala and providers and helat care workers are being encouraged to buy into the P4P by different agencies and tahe government. Individual health plans area chiming in also. It has pros and cons such as weakness that may or may not improve health care. It is suppose to help lower or slow down ER visits and physicians visits.  this instant if the providers give quality and efficent care they would and could get financial rewards if patient care improves. P4P measures performance and policy set up for putting this service in action. Discusses the effects pay-for   -performance will have on the future of health careThe P4P effects that will be seen in the future of health care is that the health care field will see it expand. Pay-for-Performance-defined a reimbursement service that will have links to payments for quality care, which will be an incentive to help improve health care quality of patients by physicians, and hospitals. In improving health care it is suppose to reduce the cost of It was expected that hospitals and providers would respond to P4P incentives.For future health care will based on quality health care and it will become a contract for reimbursement. Patients should feel like they have gotten the value of their money. One effect of future health care is those physicians and hospitals that dont participate will be at less to receive patients. Patients that have this health care plan will be more apt to seek physicians that participate. (Goldberg, L (2006) ConclusionPeople in the health care field are getting interested in    the pay for performance because the health care guidelines and regulations are changing in Medicaid, Medicare and private insurance. More hospitals and clinics and specialty facilities and rehab centers are loving receiving incentives for their participation and in the process they are saving cost to patients and insurance companies. P4P is working with insurance companies and providers for the quality of care for patients to be improved. Now managed care is now looking at pay for performance. Reimbursement being  cogitate to pay for performance is like being paid to shop for the  best bargain or the most person to fit your needs.  
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