2 ASSIGNMENTS DUE IN 24 HOURS

For this Performance Task Assessment, you will create a Quick Reference Guide for the different types of prospective payment system settings.

Submission Length: 3–4 pages in this Competency Assessment, you will create a Quick Reference Guide that compares the different prospective payment systems using the Prospective Payment System Reference Guide Template.

Professional Skills:  Written Communication  and  Information Literacy  are assessed in this Competency.

Your response to this Assessment should:

· Reflect the criteria provided in the Rubric.

· Adhere to the required assignment length.

This Assessment requires submission of one (1) document, a completed Quick Reference Guide. Save this file as IR3005_firstinitial_lastname (for example, IR3005_J_Smith).When you are ready to upload your completed Assessment, use the Assessment tab on the top navigation menu.

Instructions

Before submitting your Assessment, carefully review the rubric. This is the same rubric the Assessor will use to evaluate your submission and it provides detailed criteria describing how to achieve or master the Competency. Many students find that understanding the requirements of the Assessment and the rubric criteria help them direct their focus and use their time most productively.

Rubric

Prospective Payment System Quick Reference Guide

Consider the following types of prospective payment systems. They all have similar names, but there are unique nuances with each of them, and each has a slightly different process. It is very easy to confuse the different types, but, as a healthcare manager, being aware of and understanding each type is important.

In this Competency Assessment, you will create a Quick Reference Guide that compares the different prospective payment systems. The following requirements will be used to make the comparisons: 1) payment system (which includes reimbursement concepts), 2) benefits of each payment system, 3) drawbacks of each payment system, and 4) additional information. This guide will be in the form of a table, and you will compare four different prospective payment systems:

· Acute care PPS

· Skilled nursing facility PPS

· Ambulatory surgical center PPS

· Hospital outpatient PPS

Within the table, respond to the following:

· Describe the basic components that are consistent across all prospective payment systems

· Summarize each payment system including reimbursement concepts (e.g., diagnostic-related groups, discounting, outliers, etc.).

· Describe the benefits that each payment system offers to healthcare organizations.

· Describe the drawbacks that each payment system has for healthcare organizations.

· Include any additional information about each payment system that would be helpful to the patient

TEXTBOOK: HEALTH CARE FINANCE AND THE MECHANICS OF INSURANCE AND REIMBURSEMENT

Health Care Finance and the Mechanics of Insurance and Reimbursement

Harrington, M. K. (2015). Health care finance and the mechanics of insurance and reimbursement. Burlington, MA: Jones & Bartlett Learning.

· Chapter 7, “Medicare Prospective Payment Systems” (pp. 137–162)

Time Estimate: 60 min

WEBSITE: PROSPECTIVE PAYMENT SYSTEMS – GENERAL INFORMATION

Prospective Payment Systems – General Information

Centers for Medicare & Medicaid Services. (n.d.). Prospective payment systems – general information. Retrieved May 20, 2019, from  https://www.cms.gov/medicare/medicare-fee-for-service-payment/prospmedicarefeesvcpmtgen/index.html

Time Estimate: 30 min

WEBSITE: MEDICARE PROSPECTIVE PAYMENT SYSTEMS (PPS): A SUMMARY

Medicare Prospective Payment Systems (PPS): A Summary

American Speech-Language-Hearing Association. (n.d.). Medicare prospective payment systems (PPS): A summary. Retrieved May 20, 2019, from  https://www.asha.org/practice/reimbursement/medicare/pps_sum/

Time Estimate: 20 min

WEBSITE: MEDICARE INPATIENT PROSPECTIVE PAYMENT SYSTEM

Medicare Inpatient Prospective Payment System

American Hospital Directory. (n.d.). Medicare inpatient prospective payment system. Retrieved May 20, 2019, from  https://www.ahd.com/ip_ipps08.html

KILLED NURSING FACILITY PROSPECTIVE PAYMENT SYSTEM

Skilled Nursing Facility Prospective Payment System

Centers for Medicare & Medicaid Services. (2018). Skilled nursing facility prospective payment system. Retrieved from  https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/snfprospaymtfctsht.pdf