Drawbacks Of the Fee-For-Service Reimbursement Model
Order ID |
53563633773 |
Type |
Essay |
Writer Level |
Masters |
Style |
APA |
Sources/References |
4 |
Perfect Number of Pages to Order |
5-10 Pages |
Description/Paper Instructions
Drawbacks Of the Fee-For-Service Reimbursement Model
Describe drawbacks of the fee-for-service reimbursement model.
Describe drawbacks of the capitation reimbursement model as it relates to providing comprehensive services.
Describe how pay-for-performance impacts reimbursement rates.
Describe how resource-based relative value scale or case-based payment encourages an overuse of services.
Competency 4: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with the expectations of health care professionals.
Adhere to the rules of grammar, usage, and mechanics.
Apply APA formatting to in-text citations and references.
INSTRUCTIONS
This assessment is based on the following scenario:
Patient scenario: Your office is seeing a new patient for the first time (new patient consults are $500).
In your role as the reimbursement specialist for a large primary care office, outline the different reimbursement options to which the practice is subject for the providers in the group.
Support your assertions with at least three academic sources. This may require you to do additional independent research. You may wish to consult the Health Care Administration Undergraduate Library Research Guide before you begin any additional research.
This assessment has two parts.
Part 1: Provider Reimbursement Options
Present (at least) the four main reimbursement options that your provider in the scenario would likely have for a new patient consult. Describe the options and comment on potential drawbacks or additional considerations to take into account with each model. Also, consider the likelihood and challenges of recouping the entirety of the consult charges for the patient.
Relevant scoring guide criteria:
Describe drawbacks of the fee-for-service reimbursement model.
“Describe” means to give an account in words of (someone or something), including all the relevant characteristics, qualities, or events.
Describe drawbacks of the capitation reimbursement model as it relates to providing comprehensive services.
Describe how pay-for-performance impacts reimbursement rates.
Describe how resource-based relative value scale or case-based payment encourages an overuse of services.
Adhere to the rules of grammar, usage, and mechanics.
“Grammar” refers to the basic rules for how sentences are constructed and how words combine to make sentences (for example, word order, case, and tense).
“Usage” refers to correct word choice and phrasing, particularly with regard to the meanings of words and phrases.
“Mechanics” refers to correct use of capitalization, punctuation, and spelling.
Apply APA formatting to in-text citations and references.
Be sure to include a separate References page.
One potential way to organize this part would be as follows:
Fee-for-service.
What is it?
Consider health care spending and cost control; what are the drawbacks of this model?
Capitation.
What is it?
What are the potential drawbacks of this model for the physicians who are driven to provide comprehensive services to their patients?
Pay for performance.
What is it?
How does this model impact reimbursement rates?
Resource-based relative value scale or case-based payment.
What is it?
How can this model potentially encourage an overuse of services?
Part 2: Payment Options for Uninsured Patients
Identify and explain the potential payment options that would be available to the patient and your care provider if the patient in for the new patient consult had been uninsured. Also, be sure to discuss the ways that a patient could qualify for specific payment options, as well as the rationale for the associated appointment charge.
Relevant scoring guide criteria:
Explain payment options for uninsured patients, including how the patient would qualify for each option.
“Explain” means to make (an idea, situation, or problem) clear to someone by describing it in more detail or revealing relevant facts or ideas.
Adhere to the rules of grammar, usage, and mechanics.
Apply APA formatting to in-text citations and references.
One potential way to organize this part would be:
Medicaid.
How does the patient qualify?
Financing options.
What is this method?
Self-pay.
How would the patient be charged? A percentage of commercial contracts or a percentage of Medicare?
Charity care.
How would you screen a patient for charity care?
What process would you implement to qualify a patient for charity care?
RUBRIC
QUALITY OF RESPONSE |
NO RESPONSE |
POOR / UNSATISFACTORY |
SATISFACTORY |
GOOD |
EXCELLENT |
Content (worth a maximum of 50% of the total points) |
Zero points: Student failed to submit the final paper. |
20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. |
30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. |
40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. |
50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. |
Use of Sources (worth a maximum of 20% of the total points). |
Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. |
5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. |
10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. |
15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. |
20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. |
Grammar (worth maximum of 20% of total points) |
Zero points: Student failed to submit the final paper. |
5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors |
10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors |
15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. |
20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. |
Structure of the Paper (worth 10% of total points) |
Zero points: Student failed to submit the final paper. |
3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. |
5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. They can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper |
7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. |
10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally, the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper. |
|
|
GET THIS PROJECT NOW BY CLICKING ON THIS LINK TO PLACE THE ORDER
Also, you can place the order at www.collegepaper.us/orders/ordernow / www.phdwriters.us/orders/ordernow
|
Do You Have Any Other Essay/Assignment/Class Project/Homework Related to this? Click Here Now [CLICK ME]and Have It Done by Our PhD Qualified Writers!! |
|
|
Drawbacks Of the Fee-For-Service Reimbursement Model
PLACE THE ORDER WITH US TODAY AND GET A PERFECT SCORE!!!