Coverage & Enrollment of The Medical Programs

Overview Prepare a lecture for an introductory health care finance class on types of revenue sources for health care organizations. For each revenue source, explain the purpose of the program, how the organization is reimbursed, and the benefits of the program. Note: The assessments in this course build upon each other, so you are strongly encouraged to complete them in sequence. By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria: • • • Competency 1: Develop financial strategies to address dynamic environmental forces. (L24.2, L24.5, L17.2) • Explain the benefits of reimbursement programs. Competency 2: Analyze the cost and revenue implications for organizational changes due to environmental forces. (L18.2, L12.1) • Analyze the reimbursement process that health care organizations must undertake. Coverage & Enrollment of The Medical Programs

Competency 4: Communicate in a manner that is scholarly, professional, and consistent with expectations for professionals in health care administration. (L6.1, L6.2, L6.3, L6.4) • Explain the purpose of health care reimbursement programs. • Write content clearly and logically with the correct use of grammar, punctuation, and mechanics. • Format citations and references using the APA style. Content Sustainable health care organizations are charged with balancing clinical and fiscal facets of the operation. It has become increasingly important for health care leaders at all levels within an organization to become comfortable with financial statements and basic accounting principles. As an early careerist, you may be involved in conversations to evaluate existing and new health care service lines. You may be asked to participate in various financial activities such as team budgeting activities, developing a departmental budget, or contributing to strategic planning or finance department meetings. As a mid or advanced careerist, you may be evaluating higher-level organization financing options, determining cash flow needs, or perhaps presenting financial information to the CEO and board. Regardless of your position within the organization, a basic understanding of health care finance is a critical success factor for effective and responsible health care leadership. Questions to Consider To deepen your understanding, you are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. • • What types of accounting are you familiar with? How have you used it or seen it used? How can you use knowledge of revenue sources to help in financial forecasting? Assignment Instruction Preparation Look in the Capella University Library and on the Internet to find resources on Medicare, Medicaid, and managed care. Specifically, you need information on what each program is, how it works, and how organizations receive reimbursements from each. You will need these resources to complete this assessment. For the purpose of this assessment, suppose you work for a large health care organization that partners with the local college on a number of initiatives. As a part of that partnership, you have been asked to be a guest presenter for an introductory health care finance class. You need to explain sources of health care revenue and how the reimbursement process works. You need to prepare a 45-minute lecture on that topic. There is no prescribed format for this assessment, but you must reference at least three resources and follow the APA guidelines. Just be sure that your assessment is organized logically and your information is presented clearly. Requirements Write a 45-minute lecture plan for an introductory health care finance class. (You will not be evaluated on whether your lecture plan is actually 45 minutes in length.) The three types of revenue sources you will cover are the following: • • • • • • Medicaid. Medicare. Managed Care. For each of the revenue sources, you must do the following: Explain the purpose of the program. Analyze the process of reimbursement for health care organizations. • What steps must be taken in order to receive reimbursement for services? Coverage & Enrollment of The Medical Programs

• How complicated is each step? • What kind of information is required from the organization? • How long does it take to receive reimbursement? Explain the benefits of the program for both patients and health care organizations. The length of this assessment will vary depending on the format you use. If your completed assessment is longer than eight pages, you may need to be more concise in your writing. If you have only two pages, you have probably not fully addressed all elements of the assessment. Please include a title page and reference page, even though you would not include those in real life. Additional Requirements • • • • • • Include a title page and reference page. Number of pages: Roughly 4–7. At least three current scholarly or professional resources. APA format for in-text citations and references only. Times New Roman font, 12 point. Double-spaced. 7/8/2019 Financial Basics Scoring Guide Financial Basics Scoring Guide CRITERIA NONPERFORMANCE BASIC PROFICIENT DISTINGUISHED Explain the purpose of health care reimbursement programs. Does not explain the purpose of health care reimbursement programs. Explains the purpose of health care reimbursement programs, but the explanation does not adequately address all health care reimbursement programs. Explains the Explains the purpose of health care purpose of reimbursement programs and includes health care information on eligibility. reimbursement programs. Analyze the reimbursement process that health care organizations must undertake. Does not analyze the reimbursement process health care organizations must undertake. Describes the reimbursement process health care organizations must undertake. Analyzes the reimbursement process health care organizations must undertake. Analyzes the reimbursement process health care organizations must undertake and thoroughly addresses each step in the process, identifies the information the organization must provide, and how long it takes the organization to receive reimbursement. Explain the benefits of reimbursement programs. Does not Identifies the benefits explain the of reimbursement benefits of programs. reimbursement programs. Explains the benefits of reimbursement programs. Explains the benefits of reimbursement programs in terms of the overall financial strategy of the organization. Coverage & Enrollment of The Medical Programs

Write content clearly and logically with the correct use of grammar, punctuation, and mechanics. Does not write content clearly, logically, or with the correct use of grammar, punctuation, and mechanics. Writes with errors in clarity, logic, grammar, punctuation, and/or mechanics. Writes content clearly and logically with the correct use of grammar, punctuation, and mechanics. Writes clearly and logically with the correct use of spelling, grammar, punctuation, and mechanics; uses relevant evidence to support a central idea. Format citations and references using the APA style. Does not format citations and references using the APA style. Uses APA to format citations and references but with numerous errors. Formats citations and references using the APA style. Formats citations and references with no errors. https://courserooma.capella.edu/bbcswebdav/institution/MHA-FP/M  Coverage & Enrollment of The Medical Programs