Law Week 4 Assignment- Healthcare Finance

Healthcare Finance

Week 4 Learning Resources

Required Learning

· Getzen, T. E., & Kobernick, M. S. (2022).  Health economics & financing (6th ed.). Wiley.

· Chapter 5, “Physicians” (pp. 98–114)

· Chapter 6, “Medical Education, Organization, and Business Practices” (pp. 116–134)

· Pink, G. H., & Song, P. H. (2020).  Gapinski’s understanding healthcare financial management (8th ed.). Health Administration Press.

· Chapter 3, “Payments to Providers” (pp. 69–102)

· Lin, M. P., Revette, A., Carr, B. G., Richardson, L. D., Wiler, J. L., & Schuur, J. D. (2020).  Effect of accountable care organizations on emergency medicine payment and care redesign: A qualitative studyLinks to an external site. .  Annals of Emergency Medicine,  75(5), 597–608. https://doi.org/10.1016/j.annemergmed.2019.09.010

· Lubarsky, D. A., French, M. T., Gitlow, H. S., Rosen, L. F., & Ullmann, S. G. (2019).  Why money alone can’t (always) “nudge” physicians: The role of behavioral economics in the design of physician incentivesLinks to an external site. .  Anesthesiology,  130(1), 154–170. https://doi.org/10.1097/ALN.0000000000002373

· Mathew, R., & Cox, M. M. (2022).  Nurse practitioners and barriers to practice in primary careLinks to an external site. .  Journal of the New York State Nurses Association,  49(2), 12–15.

· Messina-Santiago, R., & Elliott, I. (2022).  Better together? The future of primary care physicians and advanced practice providersLinks to an external site. .  Family Doctor: A Journal of the New York State Academy of Family Physicians,  11(1), 18–20.

· Slater, B. J., Collings, A. T., Corvin, C., & Kandel, J. J. (2022).  Value-based surgery physician compensation model: Review of the literatureLinks to an external site. .  Journal of Pediatric Surgery,  57(9), 118–123. https://doi.org/10.1016/j.jpedsurg.2022.01.009

Required Media

Walden University, LLC. (2024). Supply of healthcare services [Video]. Walden University Canvas. https://waldenu.instructure.com

Week 4 Assignment

Healthcare Finance

To deliver healthcare services, an ACO needs to create a competent workforce that can provide health care to the patients that are in the ACO. Some integrated ACO entities already have employed physicians and mid-level providers that receive salaries from the organization, whereas other non-integrated ACO entities need to invest in external relationships with independent physicians and other providers. Since ACOs do not have managerial control over non-employed providers, additional controls and incentives may be necessary to ensure that efficiency is maximized. ACOs also need to consider the number and mix of specialists (e.g., family practice vs internal medicine) and mid-level providers (e.g., physician assistants and nurse practitioners) in delivering primary care services that can promote value. Maximizing value requires appropriate workforce decisions on supply and incentives to encourage providers to minimize costs. For this Assignment, you will examine the Week 4 Supply of Workforce Template and consider the efficiency in the supply of health services.

To prepare for this Assignment: 

· Review the scenario and Week 4 Assignment document provided to you by the instructor. Based on the financial data, conduct a financial projection (revenues, expenses, and profit) that analyzes the efficiency of the supply of health services.

· Download Week 4 Supply of Workforce Template.

Submit the template provided with calculations and a brief 1-page document, to address the following:

· Propose recommendations on the following:

· Number of physicians and nurse practitioners needed

· Reimbursement method: salary or fee-for-service

· Recommendations for financial incentives to address the challenges of supplier-induced demand 

· Recommendations for how to ensure efficiency

· Interpret the net profit from the ACO contract based on your recommendations.

· Explain the rationale behind your recommendations, including the impact made by your financial calculations.

Please see attached for week four assignment.  You must complete both the salary and FFS while the recommendations can be a one-page summary.

Week Four Supply for Healthcare

Supply takes on a prominent role in health economics because of the unique nature of what is being supplied in healthcare. Moreover, supply in healthcare is subject to many influences that are not as evident in other kinds of markets. The production of healthcare providers is more regulated and requires far more resources than the production of taxi drivers or florists, for example. Patients and family members, communities throughout the country, doctors, nurses, and providers are all grappling with the reality of the depletion of the physician workforce in our nation’s healthcare system. The workforce shortage has been increasing since before the COVID-19 pandemic—accelerating at an even more alarming rate thereafter. By 2034, according to the Association of American Medical Colleges, the demand for primary and specialty care physicians will exceed supply by a range of 37,800 to 124,000 physicians ( USA Today, June 29, 2023). This will require providers to carefully consider utilization management controls.

This week, as you explore the supply of health services, you recommend strategies for reimbursement and utilization management. You also examine efficiency in the supply of services and challenges of supplier-induced demand.