week 5 peer response
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hmgt_322_week_5_peer_respon.docx322 Week #2 response: Need a peer response to each post (Discussion). There are 2 post total
Specific Rules for Discussions
No Title page
Peer responses - Must be a minimum of 100 - 200 words and a maximum of 300 words for peer responses.
Must provide a minimum of at least one (1) reference in your discussion and peer responses.
· Urusha Honesty posted Feb 8, 2016 11:43 PM
1. a.
There is a lack of consistency in the current reimbursement and payment methodologies. There is a large gap in the interests of private and public provider’s, which makes a difference in maximizing efficiency and effectiveness versus increasing expenditures in private care. Medicaid, the primary source for the majority of patients, does not allow much cost shifting, resulting in a lack of options in who to choose as a provider. (Vraciu, R.A., 1979)(nithinmohantk, 2010)
Many people are unsure of what medical treatment entails, as a result, they are unaware of the financial impact of unneeded treatments. (Prof. J. Bozek)
High costs leave those who are not covered by employer insurance, covered by a government program or who can not afford to pay for private services or out of pocket insurance with a lack of access to healthcare. High deductibles also limit access in some cases. (nithinmohantk, 2010)
b. Strategies I would implement in response to 1a.
Creating a level of control and consistency to narrow the gap between efficiency, effectiveness and expenditures by generating a mixture of patients using different payment sources while establishing a level of high-quality care for all patients.
Offering other financing options such as discounted financing, low-interest financing and educating patients on the benefits of HSA’s when they may be available for a solution to high deductibles. Ensuring prevention education is would be a go to solution to lower costs would be a first priority. Having personnel that is aware of financing options to discuss with patients is vital.
2 .a.
A financial budget is required to present investors and stakeholders a picture of how the operation will cover fixed costs and how it will generate a profit. The stability of the organization depends on a well planned and properly executed budget. (Vraciu, R.A.,1979).
2 b.What are the key components of a financial budget of a health care organization, and what is their purpose in accomplishing the goals you identified in part 2a.
I would say preparation and planning a budget that is based on historical costs as well as forecasting based on the strategic plan is most important to create a picture of how the operation will stay afloat.
Control would be essential to maintaining the budget. Analysis of operations, analysis of financial performance and other utilization reviews would need to take place often. Assessment performance should also be done timely. I would also utilize both capitation and fee for payment services to be competitive to generate revenue.
nithinmohantk (2010). US health care system overview 1. LinkedIn Slide Share. Retrieved from http://www.slideshare.net/nithinmohantk/us-health-care-system-overview-1
Professor Jerome Bozek, UMUC. Week 5 Lecture. Retrieved from https://learn.umuc.edu/d2l/le/content/174191/viewContent/5554449/View
Vraciu, R.A. (1979). Programming, budgeting, and control in health care organization: the state of the art. Health Services Research. 14(2): 126–149
· Example of a response:
Actions for reply by James Booker at February 9 at 10:48 PM
Urusha,
This was a good post. I wanted to respond to you saying you would utilize the fee for service option. I would disagree. I feel it is not entirely too bad of an option but then the waters get murky. In healthcare , organizations are ordering extra and unnecessary tests to make more money. So with saying that, physicians would use that. The Government is already cracking down hard on violations like that. Its called the Stark Law.
Resond to ursha here:
Miguel Wolfe posted Feb 10, 2016 6:35 PM
1. As a healthcare manager:
a. Identify three major challenges healthcare organizations face with current reimbursement and payment methodologies. i.e.(consider reimbursement models under Medicare, Medicaid, Plans under Health Insurance Exchanges (Affordable Care Act), military health plans, and commercial health plans based on your readings.
Based on my readings; challenges that the Affordable Care Act face include lower reimbursement to physicians and hospitals; as well as mounting patient debt caused by high-deductible plans. A Challenge that occur in medicaid is controlling cost of the budgets during economic downturns as enrollment increases, due to loss of jobs and health benefits.
Dichiara Jacqueline( March,2015) Affordable Care Act Means Lower Reimbursement for Physicians
http://revcycleintelligence.com/news/affordable-care-act-means-lower-reimbursement-for-physicians
KaiserHealthNews (July,2015) 5 Challenges Facing Medicaid at 50 http://www.usnews.com/news/articles/2015/07/30/5-challenges-facing-medicaid-at-50
b. What actions/strategies will you implement in response to what you have identified?
In response to the challenges faced by the Affordable Care Act I would advised giving the physicians incentives that would help balance out the lowered reimbursement. These incentives may come in the form of discounts on medical. As for the mounting patient debt caused by high deductible, I would suggest a limit to how high patient debt is allowed to grow. As well as advise the patients on what services they may actually need to insure that their money is not wasted. Controlling cost for medicaid could come from limiting services to more chronic health conditions.
2 .As a healthcare manager:
. a. Why do a financial budget? What goals does it hope to accomplish?
Financial budgets are important as they help plan and monitor healthcare organization budgets and will help identify wasteful expenditures, adapt quickly as financial situation changes, and achieve financial goals.
b.What are the key components of a financial budget of a healthcare organization, and what is their purpose in accomplishing the goals you identified in part 2a.
Key components of a financial budget of a healthcare organization include a cash flow analysis which will help health management determine where is most of the money going in the organization. Having a long term strategic plan is also important, as it gives the organization order and will give the staff a goal to accomplish.
Respond to Miguel here:
