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
Volume to Value-Based payment Methodologies
Volume, Value, Based, Payment, Methodologies
Moving from volume- to value-based payment methodologies can be challenging due to
the cost of implementing them and to the variety of payment structures. The type of
value-based program that works for one health care organization may not be the right fit
for another. How do you as a health care executive determine the right structure for
your organization?
What do you need to take into consideration as you look at shifting from traditional
payment methodologies to value-based care?
For this Discussion, review the resources for this week and reflect on the challenges
health care executives might face when transitioning the payment methodology in a
health care organization to a value-based model. Consider how the move to a value-
based model might impact health care delivery for the health care organization.
With these thoughts in mind:
By Day 3
Post an explanation of how you, as a current or future health care executive, would
choose a value-based methodology for the health care organization that you currently
work in or one with which you are familiar. Describe the organization's current payment
methodology, and explain your rationale for choosing to move to your chosen model. Be
specific and provide examples.
Discussion
Continue the Discussion and respond to two of your colleagues (Each Colleagues 250
words or more (Colleague 1 250 words, Colleague 2 250 words, Total 500 words): by
providing feedback and recommendations regarding their choices of value-based
models and rationales for their choices.
Colleague 1
As a future health care executive choosing the correct value-based methodology is key.
“With the continued rise in the cost of U.S. health care, there is an increased emphasis
on value-based care methodologies. Value is defined as health outcomes achieved per
dollar spend” (Galvin, Thompson, Thompson, Parada, Eichinger, Dickens, and
Gillingham, 2019).
One organization familiar with is a military program called ‘Tricare’ which is broken into
the East and West division. This program provides the health care system in which
active, veterans, and family members can receive.
Tricare is a fee for service (FFS) program, according to Galvin, Thompson, Thompson,
Parada, Eichinger, Dickens, and Gillingham, “fee-for-service (FFS) In health care, one
of the most significant structure measures is the type of reimbursement model in which
a health care system utilizes. This payment structure drives and incentivizes all the
underlying behaviors within the system” (2019).
In addition, the risk for “FFS systems the financial risk burden lies with the payer
because providers are incentivized to over provide services which increases
reimbursement. The military’s use of the Integrated Resourcing and Incentive System
(IRIS) along with incentives for good out-comes with the National Surgical Quality
Improvement Program (NSQIP) and Joint Outpatient Experience Survey (JOES) are
important steps toward providing value-based care.
Universal collection and reporting of patient outcomes, as illustrated by the (Military
Orthopedic Tracking Injury and Outcomes) Network MOTION program, and the
utilization of integrated practice units, however, hold the promise of dramatically
accelerating the value of the care our patients receive and may contribute to the
readiness and effectiveness of our nation’s defenders” (Galvin, Thompson, Thompson,
Parada, Eichinger, Dickens and Gillingham, 2019).
References
Galvin, J. W., Thompson, J. C., Thompson, A. M., Parada, S. A., Eichinger, J. K.,
Dickens, J. F., & Gillingham, B. L. (2019). A Guide to Understanding Reimbursement
and Value-Based Care in the Military Health System. Military Medicine, 184(3/4),
e205–e210. https://doi-org.ezp.waldenulibrary.org/10.1093/milmed/usy206
Colleague 2
As a future health care executive, I would choose a value-based methodology for the
health care organization to be more like Kaiser Permanente in California. The mission is
to provide affordable, high-quality health care services and to improve the health of the
members and the communities. The values statement is "to be the model of quality
health care in the nation by being the best place to work and the best place to receive
care." Part of the mission is quality and affordability.
The overriding strategic goal is to pursue ways to trim costs out of the health care
delivery process while increasing quality. By concentrating on advanced techniques,
including Six Sigma, the health care organization will pursue this strategic objective.
The way to influence policy is to first index executive pay to the customer or patient
performance.
This will immediately drive greater accountability into the health care organization
concerning the patient experience. Then, the policy shift to providing bonuses to
operations management teams who drive costs out of health care delivery will also be
very effective.
Lastly, the Board of Directors would create a culture of continuous improvement by
setting metrics and analytics for company performance that center first on shared
information and collaboration. By inventing collaboration, the company's overall
efficiency will significantly improve, and patient satisfaction will also increase.
Reference:
Collins, J.C., & Porras, J.I. (1996). Building your company's vision and mission. Harvard
Business Review, 74, 65
Stewart, T.A. (1996). A refreshing change:
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. |
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