Value Driven Healthcare Discussion
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Learning Resources
Required Readings
Penner, S. J. (2017). Economics and financial management for nurses and nurse leaders (3rd ed.). New York, NY: Springer Publishing.
- Chapter 12, “Assessing Financial Health” (pp. 365–395)
Centers for Medicare and Medicaid Services. (2019). Bundled payments for care improvement (BPCI) initiative: General information. Retrieved from https://innovation.cms.gov/initiatives/Bundled-Pay…
Centers for Medicare and Medicaid Services. (n.d.a). Roadmap for implementing value driven healthcare in the traditional Medicare Fee-for-Service program. Retrieved September 25, 2018, from https://www.cms.gov/Medicare/Quality-Initiatives-P…
Centers for Medicare and Medicaid Services. (n.d.b). Roadmap for quality measurement in the traditional Medicare Fee-for-Service program. Retrieved September 25, 2018, from https://www.cms.gov/Medicare/Quality-Initiatives-P…
Centers for Disease Control and Prevention, National Center for Health Statistics. (2017). Hospital utilization (in non-federal short-stay hospitals). Retrieved from https://www.cdc.gov/nchs/fastats/hospital.htm
Document: Week 2 Assignment Template (Word document)
Discussion: Keeping Costs Under Control
Keep costs under control, reduce spending, and provide quality care: These could be the tenets for any healthcare provider. Oftentimes, when you discuss finances in a healthcare setting, you might focus on spending and keeping costs within your budget while putting quality in the backseat to other goals. Value-driven healthcare and quality measures in healthcare should not be conflicting ideas. The largest organizations responsible for paying providers for care are Medicare and Medicaid, and, like many other organizations, they want to spend less while still providing excellent care. This can be challenging as more and more emphasis is placed on spending.
While these two ideas are not in direct opposition, how decisions about spending are made based on these two perspectives can be very different. Value-driven healthcare strives to create a direct relationship of quality to reimbursement, while quality measurement in healthcare works to improve health through efficiency and utilization of resources. As a provider of healthcare, these two ideas drive financial decisions such as cost control and risk in relation to quality of care and quality measures.
In this week’s Discussion, choose one of the two perspectives to discuss. After posting on your perspective, you will respond to at least two colleagues, one of whom chose a different perspective.
To Prepare:
- Select one of two perspectives to address in this Discussion:
- Value-driven healthcare
- Measuring care for traditional fee-for-service
- Locate an organization that is implementing an initiative to address the perspective that you chose.
- Review the Resources for this week and consider the relationship between costs, patient outcomes, and care transitions as it relates to the perspective you chose.
- Reflect on how the perspective may impact cost reduction and the challenge for maintaining healthcare quality. Value Driven Healthcare Discussion
BY DAY 4
Post a comprehensive response to the following:
- Identify the perspective that you chose (either value-driven healthcare or measuring care for traditional fee-for-service in healthcare)
- Identify the organization that you found that is implementing an initiative relating to the selected perspective
- Summarize the initiative, including all policies and procedures that stem from it
- Explain how this initiative will impact cost control and quality of care within the organization
- Explain how risk and uncertainty should be factored into cost-control decisions in healthcare
BY DAY 6
Respond to at least two of your colleagues:
- One who addressed the same perspective
- One who addressed a different perspective
Support or expand upon your colleague’s posting. Suggest additional ways that cost control and quality of care will be impacted by the initiative. Expand upon how risk and uncertainty should be factored into cost-control decision-making. Value Driven Healthcare Discussion
SUBMISSION AND GRADING INFORMATION
Grading Criteria
To access your rubric:
Week 2 Discussion Rubric
Post by Day 4 and Respond by Day 6
To participate in this Discussion:
Week 2 Discussion
Assignment: What to Use, When to Use It?
As more payors look at the cost of reimbursement for care and patients take on more of the cost of healthcare, it has become increasingly more important for all parties to know what the cost is for procedures, care, and equipment. Government agencies are becoming more involved in regulating care and cost, and one way that is being accomplished is by demanding cost transparency.
While the transparency requirements for private non-profit, private for-profit, and state- or government-run hospitals may differ, all hospitals are being encouraged, in one way or another, to share information publicly regarding costs and care.
Much of this public information can be found online. While most may not share all of their financial reports with the public, many healthcare professionals may need to look at any number of documents to cut costs, limit wasted resources, or improve efficiency and quality. Each type of financial report provides specific types of information, and knowing which one to use to achieve a goal is an important step.
For this Assignment, using the Learning Resources and other resources, you will analyze the information found in each of the four types of financial documents and then provide examples of how they would be used by a healthcare manager. Value Driven Healthcare Discussion
To Prepare for this Assignment:
- Review each of the four documents commonly found in financial reports: balance sheet, income statement, cash-flow statement, and ratio analysis
- Consider the different perspectives of healthcare managers, and select one perspective to address: a manager who works in a hospital department, nursing unit, nursing home, or doctor’s office/practice.
The Assignment: Analysis of Financial Statements (Template)
Complete the Assignment Template that provides a detailed explanation of each of the following four documents commonly found in financial reports from your selected perspective. Consider the ways that these documents would be used in your chosen setting and what they would be used for:
- Balance sheet
- Income statement
- Cash-flow statement
- Ratio analysis
Make sure to follow APA guidelines and support your Assignment with references.