Essay

IHP 630 Milestone Two Guidelines and Rubric Overview: In terms of reimbursement and financial principles (specifically relating to the revenue cycle), you will determine what federal and state funding is available for healthcare organizations. As you continue to explore payment systems from the view of the hospital administrator, consider what actions you might take to ensure your facility meets compliance requirements. Additionally, you will research the importance of implementing policies and procedures that are designed to ensure timely reimbursement. Prompt: Submit a draft of the Federal and State Payment Systems portion of your research and analysis. Be sure to address all critical elements as listed below. Specifically, the following critical elements must be addressed:

III. Federal and State Payment Systems: a) Federal and State Regulations: Considering the recent changes in economic policy at the federal and state levels, what changes in federal and state

regulations present the most concern for healthcare leaders? Be sure to provide support for your response. b) Reporting Requirements: Analyze the reporting guidelines required by Medicaid and Medicare and other government payment systems. What are

the opportunities and challenges for healthcare leaders in meeting reporting requirements? c) Compliance Standards and Financial Principles: Analyze how healthcare organizations in general utilize financial principles to ensure compliance

with government standards. d) Government Payer Types: Considering Medicaid, Medicare, and other government payer systems, what strategies would you recommend

organizations implement in order to receive full reimbursement on claims as well as to improve timeliness of this reimbursement? Be sure to justify your recommendations.

Rubric Guidelines for Submission: Your draft of the Federal and State Payment Systems portion of your research and analysis should be 2–3 pages in length and should be double-spaced in 12-point Times New Roman font with one-inch margins. All citations and references should be formatted according to current APA guidelines. Include at least two references.

Critical Elements Proficient (100%) Needs Improvement (70%) Not Evident (0%) Value

Federal and State: Regulations

Logically assesses the changes in federal and state regulations that present the most concern for healthcare leaders, supporting response

Assesses the changes in federal and state regulations that present the most concern for healthcare leaders, supporting response but with gaps in logic, detail, or relevant support

Does not assess the changes in federal and state regulations that present the most concern for healthcare leaders

25

Federal and State: Reporting Requirements

Accurately analyzes reporting guidelines required by government payment systems for the opportunities and challenges facing healthcare leaders in meeting reporting requirements

Analyzes reporting guidelines required by government payment systems for the opportunities and challenges facing healthcare leaders in meeting reporting requirements but with gaps in accuracy or detail

Does not analyze reporting guidelines required by government payment systems for the opportunities and challenges facing healthcare leaders in meeting reporting requirements

25

Federal and State: Compliance Standards

Accurately analyzes how healthcare organizations utilize financial principles for ensuring compliance with government standards

Analyzes how healthcare organizations utilize financial principles for ensuring compliance with government standards but with gaps in accuracy or detail

Does not analyze how healthcare organizations utilize financial principles for ensuring compliance with government standards

20

Federal and State: Government Payer Types

Recommends appropriate strategies for organizations to receive full reimbursement on claims and improve timeliness of reimbursement from government payers, justifying recommendations

Recommends strategies, but they are not appropriate for organizations to receive full reimbursement on claims and improve timeliness of reimbursement from government payers or response has gaps in detail or relevant justification

Does not recommend strategies for organizations to receive full reimbursement on claims and improve timeliness of reimbursement from government payers

20

Articulation of Response Submission has no major errors related to citations, grammar, spelling, syntax, or organization

Submission has major errors related to citations, grammar, spelling, syntax, or organization that negatively impact readability and articulation of main ideas

Submission has critical errors related to citations, grammar, spelling, syntax, or organization that prevent understanding of ideas

10

Total 100%