Final Project M9

Competencies

In this project, you will demonstrate your mastery of the following competencies:

Use financial management and teamwork principles to guide and improve strategic planning and reimbursement

Recommend models and methods to inform and improve revenue-cycle processes

Analyze federal, state, and third-party payer regula!ons and repor!ng guidelines for reimbursement compliance

Scenario

You are a healthcare consultant hired by a large healthcare organiza!on. The organiza!on has some new members on the

board of directors who have requested an orienta!on on the organiza!on’s strategic planning, revenue-cycle processes, and

reimbursement-compliance processes. As a consultant, you have been asked to educate the new board members at their next

retreat on these areas, highligh!ng internal strengths and weaknesses, as well as external opportuni!es and barriers that

might impact financial performance and reimbursement.

Direc!ons

Create a PowerPoint presenta!on with a separate speaker notes document for educa!ng the board of directors on strategic

planning, revenue-cycle processes, and reimbursement compliance processes. In your speaker notes, be sure to indicate

which notes belong with each slide.

If you need wri!ng support, access the Online Wri!ng Center through the Academic Support module of your course.

Specifically, you must address the following:

1. Introduc!on: Introduce your presenta!on, including a concise, high-level overview of what topics and informa!on will

be covered in the presenta!on.

2. Strategic Planning: Determine how overall strategic planning can poten!ally be improved by applying financial

management and teamwork principles within your organiza!on.

A. Financial Management Principles: Summarize how other healthcare organiza!ons have successfully used

financial management principles to inform and improve their overall strategic planning.

B. Collabora!ve Teamwork Integra!on: Describe from the lens of a healthcare administrator how collabora!ve

teamwork principles can be integrated into your healthcare organiza!on, par!cularly principles related to

revenue cycle processes.

3. Staffing Impact: Evaluate how staffing across the department impacts revenue cycle outcomes and team

performance.

4. Healthcare Reimbursement: Analyze the importance of improving healthcare reimbursement processes for the

organiza!on and various stakeholders.

A. Improvement Processes: Determine which principles and processes your healthcare organiza!on can either

implement or update within their policies, explaining how these implementa!ons or updates will improve

overall reimbursements for various stakeholders.

B. Payer Model Advantages and Disadvantages: Analyze the advantages and disadvantages of both

governmental and nongovernmental payer models, as well as their impact on various stakeholders.

C. Managed Care Plan Advantages and Disadvantages: Analyze from the lens of a healthcare administrator the

advantages and disadvantages of a managed care plan and their impact on various stakeholders.

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5. Revenue-Cycle Process: Analyze the importance of improving revenue-cycle processes for the organiza!on and

various stakeholders.

A. Models and Methods: Evaluate which model(s) and method(s) you believe will posi!vely impact revenue-cycle

processes within your healthcare organiza!on.

B. Workflow Assessment Findings: Explain the effec!veness of current internal workflows for your healthcare

organiza!on based on your completed assessment, as well as how these workflows can be adjusted to further

enhance the organiza!on’s cash flow and overall financial strength.

6. Reimbursement Compliance: Analyze the overall impact of current federal, state, and third-party payer regula!ons

and repor!ng guidelines on reimbursement compliance for the organiza!on.

A. Regula!ons: Analyze at least one federal, one state, and one third-party payer regula!on that could affect

your healthcare organiza!on, providing examples of both posi!ve and nega!ve impacts on various

stakeholders for each regula!on you iden!fy.

B. Repor!ng Requirements: Analyze at least one federal, one state, and one third-party payer repor!ng

requirement that could affect your healthcare organiza!on, providing examples of both posi!ve and nega!ve

impacts on various stakeholders for each repor!ng requirement you iden!fy.

C. Technology and System Impacts: Evaluate how required technology and system impacts for repor!ng

guidelines and regulatory compliance affect your healthcare organiza!on, both posi!vely and nega!vely.

7. Recommenda!ons: Recommend changes your healthcare organiza!on can make to maximize reimbursement

opportuni!es for pa!ents, staff, and various stakeholders.

Your presenta!on should be evidence based. Your cita!ons should be from your independent search for evidence (not from

the scenario, textbook, or module resources) of credible sources and be current within the last five years. You are required to

cite a minimum of five sources overall. Refer to the IHP 630 Library Guide located in the Start Here sec!on of the course for

addi!onal support.

What to Submit

To complete this project, you must submit the following:

Strategic Planning Educa!on Presenta!on

Your submission should be a 15- to 18-slide PowerPoint presenta!on (in addi!on to !tle and reference slides). Sources should

be cited according to APA style.

Strategic Planning Educa!on Presenta!on Speaker Notes

Your submission should be a 12- to 14-page Word document with 12-point Times New Roman font, double spacing, and one-

inch margins. Sources should be cited according to APA style.

Criteria Exemplary (100%) Proficient (90%) Needs

Improvement (70%) Not Evident (0%) Value

Introduc!on Exceeds proficiency in an excep!onally clear and insigh$ul manner, using industry-specific language

Introduces the presenta!on and includes a concise, high-level overview of what topics and informa!on will be covered

Shows progress toward proficiency, but with errors or omissions

Does not a%empt criterion

4

Project Rubric

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Strategic Planning Exceeds proficiency in an excep!onally clear and insigh$ul manner, using industry-specific language

Determines how overall strategic planning can poten!ally be improved by applying financial management and teamwork principles within the organiza!on

Shows progress toward proficiency, but with errors or omissions

Does not a%empt criterion

5

Strategic Planning: Financial

Management Principles

Exceeds proficiency in an excep!onally clear and insigh$ul manner, using industry-specific language

Summarizes how other healthcare organiza!ons have successfully used financial management principles to inform and improve their overall strategic planning

Shows progress toward proficiency, but with errors or omissions

Does not a%empt criterion

4

Strategic Planning:

Collabora!ve Teamwork Integra!on

Exceeds proficiency in an excep!onally clear and insigh$ul manner, using industry-specific language

Describes from the lens of a healthcare administrator how collabora!ve teamwork principles can be integrated into the healthcare organiza!on, par!cularly principles related to revenue-cycle processes

Shows progress toward proficiency, but with errors or omissions

Does not a%empt criterion

4

Staffing Impact Exceeds proficiency in an excep!onally clear and insigh$ul manner, using industry-specific language

Evaluates how staffing across the department impacts revenue cycle outcomes and team performance

Shows progress toward proficiency, but with errors or omissions

Does not a%empt criterion

4

Healthcare Reimbursement

Exceeds proficiency in an excep!onally clear and insigh$ul manner, using industry-specific language

Analyzes the importance of improving healthcare reimbursement processes for the organiza!on and various stakeholders

Shows progress toward proficiency, but with errors or omissions

Does not a%empt criterion

5

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Healthcare Reimbursement:

Improvement Processes

Exceeds proficiency in an excep!onally clear and insigh$ul manner, using industry-specific language

Determines which principles and processes the healthcare organiza!on can either implement or update within its policies, explaining how these implementa!ons or updates will improve overall reimbursements for various stakeholders

Shows progress toward proficiency, but with errors or omissions

Does not a%empt criterion

4

Healthcare Reimbursement:

Payer Model Advantages and Disadvantages

Exceeds proficiency in an excep!onally clear and insigh$ul manner, using industry-specific language

Analyzes the advantages and disadvantages of both governmental and nongovernmental payer models, as well as their impact on various stakeholders

Shows progress toward proficiency, but with errors or omissions

Does not a%empt criterion

5

Healthcare Reimbursement: Managed Care

Plan Advantages and

Disadvantages

Exceeds proficiency in an excep!onally clear and insigh$ul manner, using industry-specific language

Analyzes from the lens of a healthcare administrator the advantages and disadvantages of a managed care plan and its impact on various stakeholders

Shows progress toward proficiency, but with errors or omissions

Does not a%empt criterion

5

Revenue Cycle Process

Exceeds proficiency in an excep!onally clear and insigh$ul manner, using industry-specific language

Analyzes the importance of improving revenue- cycle processes for the organiza!on and various stakeholders

Shows progress toward proficiency, but with errors or omissions

Does not a%empt criterion

5

Revenue Cycle Process: Models

and Methods

Exceeds proficiency in an excep!onally clear and insigh$ul manner, using industry-specific language

Evaluates which model(s) and method(s) are believed to posi!vely impact revenue cycle processes within the healthcare organiza!on

Shows progress toward proficiency, but with errors or omissions

Does not a%empt criterion

4

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Revenue Cycle Process:

Workflow Assessment

Findings

Exceeds proficiency in an excep!onally clear and insigh$ul manner, using industry-specific language

Explains the effec!veness of current internal workflows for the healthcare organiza!on based on the assessment you completed, as well as how these workflows can be adjusted to further enhance cash flow and overall financial strength for the organiza!on

Shows progress toward proficiency, but with errors or omissions

Does not a%empt criterion

4

Reimbursement Compliance

Exceeds proficiency in an excep!onally clear and insigh$ul manner, using industry-specific language

Analyzes the overall impact of current federal, state, and third-party payer regula!ons and repor!ng guidelines on reimbursement compliance for the organiza!on

Shows progress toward proficiency, but with errors or omissions

Does not a%empt criterion

5

Reimbursement Compliance: Regula!ons

Exceeds proficiency in an excep!onally clear and insigh$ul manner, using industry-specific language

Analyzes at least one federal, one state, and one third-party payer regula!on that could affect the healthcare organiza!on, providing examples of both posi!ve and nega!ve impacts on various stakeholders for each regula!on or repor!ng requirement iden!fied

Shows progress toward proficiency, but with errors or omissions

Does not a%empt criterion

4

Reimbursement Compliance:

Repor!ng Requirements

Exceeds proficiency in an excep!onally clear and insigh$ul manner, using industry-specific language

Analyzes at least one federal, one state, and one third-party payer repor!ng requirement that could affect the healthcare organiza!on, providing examples of both posi!ve and

Shows progress toward proficiency, but with errors or omissions

Does not a%empt criterion

4

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nega!ve impacts on various stakeholders for each regula!on or repor!ng requirement iden!fied

Reimbursement Compliance:

Technology and System Impacts

Exceeds proficiency in an excep!onally clear and insigh$ul manner, using industry-specific language

Evaluates how required technology and system impacts for repor!ng guidelines and regulatory compliance affect the healthcare organiza!on, both posi!vely and nega!vely

Shows progress toward proficiency, but with errors or omissions

Does not a%empt criterion

4

Recommenda!ons Exceeds proficiency in an excep!onally clear and insigh$ul manner, using industry-specific language

Recommends changes the healthcare organiza!on can make to maximize reimbursement opportuni!es for pa!ents, staff, and various stakeholders

Shows progress toward proficiency, but with errors or omissions

Does not a%empt criterion

5

Ar!cula!on of Response

Exceeds proficiency in an excep!onally clear and insigh$ul manner

Clearly conveys meaning with well- designed presenta!on slides, correct grammar, sentence structure, and spelling, demonstra!ng an understanding of audience and purpose

Shows progress toward proficiency, but with errors in presenta!on slide design, grammar, sentence structure, and spelling, nega!vely impac!ng readability

Submission has cri!cal errors in presenta!on slide design, grammar, sentence structure, and spelling, preven!ng understanding of ideas

9

Scholarly and Professional

Sources

Incorporates more than five scholarly and professional, current (within the last five years) sources, or use of sources is excep!onally insigh$ul

Incorporates five scholarly and professional, current (within the last five years) sources that support claims

Incorporates fewer than five scholarly and professional, current (within the last five years) sources, or not all sources support claims

Does not incorporate sources

8

APA Style Formats in-text Formats in-text Formats in-text Does not format in- 8

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cita!ons and reference list according to APA style with no errors

cita!ons and reference list according to APA style with fewer than five errors

cita!ons and reference list according to APA style with five or more errors

text cita!ons and reference list according to APA style

Total: 100%

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