Each reply must be at least 450 words a peice. Each thread and reply must contain at least 2 references and 1 instance of biblical integration. Current APA format must be used.
classmate #1-
Colossians 3:23 says, “Whatever you do, work heartily, as for the Lord and not for men.” As a part of quality assurance, the government has instilled various programs as incentives for various health care facilities and health care professionals. Like the Meaningful Use program, other programs that are offered by the government “look to incentivize healthcare providers through demonstrating the delivery of quality healthcare and a commitment to quality patient outcomes” (Harrington, 2016, p. 269). Holmstrom (2017) reported that an incentive program or system that is properly designed will consider the full collection of services that a healthcare provider or facility “can engage in, the array of instruments, many nonfinancial, that are available to influence individuals and consider the factors that motivate them in different settings” (p. 1735). Two of the incentive programs that we will look at further are the Pay-for-Performance (P4P) program and the Value-Based Purchasing (VBP) program. Both programs are based on quality care, but P4P deals with healthcare providers while VBP deals with acute care hospitals.
Up until the 1990s, healthcare providers were reimbursed based on a fee-for-service system. Entering into the 1990s, healthcare payers shifted to a managed-care approach that included primary care physicians and case managers. With the continued escalating healthcare costs with little to no improvement in the quality of healthcare services, the P4P payer system was introduced in the early 2000s. When healthcare providers meet or exceed agreed-upon quality measures or performance goals, they will be provided with a bonus from the P4P program (Harrington, 2016). Healthcare providers can also be penalized for not providing quality care, not reducing healthcare costs, and even performance that is not improving. This places pressures on the healthcare providers to ensure that any healthcare services provided to patients are “safe, effective, patient-centered, timely and efficient in its delivery, and equitable for the patient” (Harrington, 2016, p. 271). Quality measures that are imposed on healthcare providers are categorized as process measures, outcome measures, patient experience, and structure measures. P4P payments to service providers are then calculated based on services rendered, the quality of services, and efficiency measures. Harrington (2016) stated that the overarching goal for the P4P program is to accurately align both the incentive program itself and the payment to providers’ processes and goal in order to eventually “produce better outcomes for the patient that will ultimately result in lower costs for the payer, provider, and patient” (p. 273). In comparison, the VBP program bases its program on a majority of the same provisions, but the program operates and requires different measures to differentiate warrant of payment.
The VBP program is an initiative by the Centers for Medicare and Medicaid Services (CMS) “that rewards acute-care hospitals with incentive payments based on the quality of care that they provide to the beneficiary/patient that is on Medicare while in” the health facilities care (Harrington, 2016, p. 274). The VBP program essentially rewards healthcare providers for delivering both quality and efficient clinical care. The VBP program can be complex but basically, any incentive payment is based on how well inpatient healthcare services perform based on each measure or on how much improvement, or lack thereof, has been made in that specific area since the previous measurement or baseline period. Just as in P4P, there are a handful of quality domains that hospitals are measures on, these include—the clinical process of care, patient experience of care, outcome, and efficiency. Any healthcare facility that participates in the VBP program is not only under a microscope, so to say, but also their performance is completely transparent to the public. Information gathered on a hospital’s performance in the VBP program is posted periodically for public review. This information includes “the hospital’s performance on each measure that applies, the hospital’s performance on each condition or procedure, and the hospital’s total performance” (Harrington, 2016, p. 278). Chee, Ryan, Wasfy, and Borden (2016) reported that VBP programs “will play a significant role in healthcare delivery for years to come, and they will serve as an opportunity for providers to build the infrastructure needed for value-oriented care” (p. 2197). Both the VBP program and the P4P program have initiated measures for improving the quality of healthcare services and healthcare professionals’ performance, while aiming at reducing healthcare costs. The overall impact of both the P4P program and the VBP program on any healthcare organization that is participating is that the overall financial health of the healthcare organization is directly affected by any unfavorable outcomes.
References
American Bible Society. (2000). The holy bible, containing the old and new testaments.
Chee, T. T., Ryan, A. M., Wasfy, J. H., & Borden, W. B. (2016). Current state of value-based purchasing
programs. Circulation, 133(22), 2197-2205. doi:10.1161/CIRCULATIONAHA.115.010268
Harrington, M. K. (2016). Health care finance and the mechanics of insurance and
reimbursement. Burlington, MA: Jones & Bartlett, 2016. ISBN: 9781284026122.
Holmstrom, B. (2017). Pay for performance and beyond. American Economic Review, 107(7), 1753-1777.
doi:10.1257/aer.107.7.1753
……………………………………………………………………………………………………………………………………………………………………….
classmate #2-
The U.S. health care delivery system does not provide consistent, high quality medical care to all people (Institute of Medicine, 2001). Americans should be able to count on the quality of care they pay for, as to meet their needs and are based on the best scientific knowledge (Institute of Medicine, 2001). To initiate process of change in the area of quality, there is a need for changes in the areas of applying evidence to health care delivery; using information technology; preparing workforce; and aligning payment policies with quality improvement (Institute of Medicine, 2001).
It has been widely adopted by health care providers, and it seems it would improve the quality of care, however, research finds very mixed evidence of that result, as there is no evidence between P4P and actual improvement of quality, nor the evidence exists that hospitals, which improved in some areas, were able to sustain the improvements (Warner et al., 2011). Studies from U.S. fail to find any improvements made in care process, however, the P4P did decrease readmission rates for Medicare beneficiaries (Mendelson et al., 2017).
The Hospital Value Based Purchasing (VBP) Program is a CMS initiative that rewards acute care hospitals with incentive payments based on the quality of care that they provide to Medicare beneficiary under their care (Harrington, 2016). The VBP was established under the ACA in 2010 and begun applying its payments for the fiscal year 2013 and had an impact on 2,985 hospitals across country (Harrington, 2016). There are about 3,000 hospitals across country that are eligible for VBP (Harrington, 2016), which are penalized or rewarded based on how well they perform on certain quality measures. VBP refers to a set of performance-based payment strategies that link financial incentives to health care providers’ performance on a set of defined measures to achieve better value (Damberg et al., 2014). VBP program excludes some hospitals that do not have a minimum number of cases from participation, like psychiatric institutions, oncology centers, or pediatric facilities; and hospitals that do not participate in the Hospital Inpatient Quality Reporting Program (Whitman, 2016). This year, CMS announced several changes to VBP, introducing four domains on hospital scores, with patient and caregiver centered experience and care coordination; safety; efficiency and cost reduction, removed two measures from clinical care and added a care transition dimension (Whitman, 2016).
Past decade has been a one big experiment with pay-for- performance payment systems, primarily with P4P. However, we still know very little about how to design and implement VBP programs to achieve stated goals and what constitutes as a successful program (Damberg et al., 2014). As of today, hospitals are assessed based on comparison to its peers and its own performance over time. According to research, about 1,600 hospitals will see bonuses from Medicare in 2017 under VBP (Whitman, 2016). The lowest performing hospitals will see a reduction in DRG payments of 1.83%, and the highest performing hospitals will see an increase of more than 4% (Whitman, 2016). Compering numbers of hospitals from 2016 to 2017, numbers of hospitals that payments were deducted grew from 1,236 to 1,343, accordingly (Whitman, 2016). According to researchers and critiques of VBP, this design has a flow, as it set up as a tournament style, in which hospitals are stacked up against each other, and really do not know how they perform until very end (Whitman, 2016). With this year’s changes in major domains on which hospitals are scored, we will gain new perspective on how progress on quality can be accelerated when pay-for-performance programs reward both achievement and improvement (Whitman, 2016).
Since we are discussing pay for performance programs, I thought it was fitting to talk about earthly rewards. In the bible there is a scripture that says, “whatever you do, work heartily, as for the Lord and not for men, knowing that from the Lord you will receive the inheritance as your reward. You are serving the Lord Christ” (Colossians 3:23-24, NIV). Everything that we do as healthcare administrators we should look at it as a service to the Lord. We should do it gladly and to the upmost of our ability. We are his servants as we do his will on earth the reward is the individual that we bring to Christ just based on our day to day operations. The pay for performance program is set up the same way as the bonus or reward is based on exceeding the quality standard that is set.
Reference
Damberg, C., Sorbero, M., Lovejoy, S., Martsolf, G., & Mandel, D. (2014). Measuring
success in health care value-based purchasing programs: Findings from an environmental scan, literature review, and expert panel discussion. RAND Health Quarterly. Vol. 4, No. 3. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC51613…
Harrington, M. (2016). Health care finance and the mechanics of insurance and reimbursement.
J&B Learning.
Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st
century. National Academies Archives. Retrieved from: http://www.nationalacademies.org/hmd/~/media/Files…
Mendelson, A., Kondo, K., Damberg, C., Low, A., & Kansagara, D. (2017). The effect of P4P
on health, health care use, and process of care: A systematic review. Annals of Internal Medicine. Retrieved from: http://annals.org/aim/fullarticle/2596395/effects-…
Warner, R., Kolstad, J., Stuart, E., & Polsky, D. (2011). The effect of P4P in hospitals: Lessons
for quality improvement. Health Affairs. Vol. 30, No. 4. Retrieved from: https://www.healthaffairs.org/doi/full/10.1377/hlt…
Whitman, E. (2016). Fewer hospitals earn Medicare bonuses under value-based purchasing.
Modern Healthcare. Retrieved from: http://www.modernhealthcare.com/article/20161101/N…
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HRM532 Sustainable Talent Management
/in Uncategorized /by JosephWith the same talent management strategy in mind from Assignment 3, write a six to eight (6-8) page paper in which you:
Your assignment must follow these formatting requirements:
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Incentive Programs in Healthcare discussion
/in Uncategorized /by JosephEach reply must be at least 450 words a peice. Each thread and reply must contain at least 2 references and 1 instance of biblical integration. Current APA format must be used.
classmate #1-
Colossians 3:23 says, “Whatever you do, work heartily, as for the Lord and not for men.” As a part of quality assurance, the government has instilled various programs as incentives for various health care facilities and health care professionals. Like the Meaningful Use program, other programs that are offered by the government “look to incentivize healthcare providers through demonstrating the delivery of quality healthcare and a commitment to quality patient outcomes” (Harrington, 2016, p. 269). Holmstrom (2017) reported that an incentive program or system that is properly designed will consider the full collection of services that a healthcare provider or facility “can engage in, the array of instruments, many nonfinancial, that are available to influence individuals and consider the factors that motivate them in different settings” (p. 1735). Two of the incentive programs that we will look at further are the Pay-for-Performance (P4P) program and the Value-Based Purchasing (VBP) program. Both programs are based on quality care, but P4P deals with healthcare providers while VBP deals with acute care hospitals.
Up until the 1990s, healthcare providers were reimbursed based on a fee-for-service system. Entering into the 1990s, healthcare payers shifted to a managed-care approach that included primary care physicians and case managers. With the continued escalating healthcare costs with little to no improvement in the quality of healthcare services, the P4P payer system was introduced in the early 2000s. When healthcare providers meet or exceed agreed-upon quality measures or performance goals, they will be provided with a bonus from the P4P program (Harrington, 2016). Healthcare providers can also be penalized for not providing quality care, not reducing healthcare costs, and even performance that is not improving. This places pressures on the healthcare providers to ensure that any healthcare services provided to patients are “safe, effective, patient-centered, timely and efficient in its delivery, and equitable for the patient” (Harrington, 2016, p. 271). Quality measures that are imposed on healthcare providers are categorized as process measures, outcome measures, patient experience, and structure measures. P4P payments to service providers are then calculated based on services rendered, the quality of services, and efficiency measures. Harrington (2016) stated that the overarching goal for the P4P program is to accurately align both the incentive program itself and the payment to providers’ processes and goal in order to eventually “produce better outcomes for the patient that will ultimately result in lower costs for the payer, provider, and patient” (p. 273). In comparison, the VBP program bases its program on a majority of the same provisions, but the program operates and requires different measures to differentiate warrant of payment.
The VBP program is an initiative by the Centers for Medicare and Medicaid Services (CMS) “that rewards acute-care hospitals with incentive payments based on the quality of care that they provide to the beneficiary/patient that is on Medicare while in” the health facilities care (Harrington, 2016, p. 274). The VBP program essentially rewards healthcare providers for delivering both quality and efficient clinical care. The VBP program can be complex but basically, any incentive payment is based on how well inpatient healthcare services perform based on each measure or on how much improvement, or lack thereof, has been made in that specific area since the previous measurement or baseline period. Just as in P4P, there are a handful of quality domains that hospitals are measures on, these include—the clinical process of care, patient experience of care, outcome, and efficiency. Any healthcare facility that participates in the VBP program is not only under a microscope, so to say, but also their performance is completely transparent to the public. Information gathered on a hospital’s performance in the VBP program is posted periodically for public review. This information includes “the hospital’s performance on each measure that applies, the hospital’s performance on each condition or procedure, and the hospital’s total performance” (Harrington, 2016, p. 278). Chee, Ryan, Wasfy, and Borden (2016) reported that VBP programs “will play a significant role in healthcare delivery for years to come, and they will serve as an opportunity for providers to build the infrastructure needed for value-oriented care” (p. 2197). Both the VBP program and the P4P program have initiated measures for improving the quality of healthcare services and healthcare professionals’ performance, while aiming at reducing healthcare costs. The overall impact of both the P4P program and the VBP program on any healthcare organization that is participating is that the overall financial health of the healthcare organization is directly affected by any unfavorable outcomes.
References
American Bible Society. (2000). The holy bible, containing the old and new testaments.
Chee, T. T., Ryan, A. M., Wasfy, J. H., & Borden, W. B. (2016). Current state of value-based purchasing
programs. Circulation, 133(22), 2197-2205. doi:10.1161/CIRCULATIONAHA.115.010268
Harrington, M. K. (2016). Health care finance and the mechanics of insurance and
reimbursement. Burlington, MA: Jones & Bartlett, 2016. ISBN: 9781284026122.
Holmstrom, B. (2017). Pay for performance and beyond. American Economic Review, 107(7), 1753-1777.
doi:10.1257/aer.107.7.1753
……………………………………………………………………………………………………………………………………………………………………….
classmate #2-
The U.S. health care delivery system does not provide consistent, high quality medical care to all people (Institute of Medicine, 2001). Americans should be able to count on the quality of care they pay for, as to meet their needs and are based on the best scientific knowledge (Institute of Medicine, 2001). To initiate process of change in the area of quality, there is a need for changes in the areas of applying evidence to health care delivery; using information technology; preparing workforce; and aligning payment policies with quality improvement (Institute of Medicine, 2001).
It has been widely adopted by health care providers, and it seems it would improve the quality of care, however, research finds very mixed evidence of that result, as there is no evidence between P4P and actual improvement of quality, nor the evidence exists that hospitals, which improved in some areas, were able to sustain the improvements (Warner et al., 2011). Studies from U.S. fail to find any improvements made in care process, however, the P4P did decrease readmission rates for Medicare beneficiaries (Mendelson et al., 2017).
The Hospital Value Based Purchasing (VBP) Program is a CMS initiative that rewards acute care hospitals with incentive payments based on the quality of care that they provide to Medicare beneficiary under their care (Harrington, 2016). The VBP was established under the ACA in 2010 and begun applying its payments for the fiscal year 2013 and had an impact on 2,985 hospitals across country (Harrington, 2016). There are about 3,000 hospitals across country that are eligible for VBP (Harrington, 2016), which are penalized or rewarded based on how well they perform on certain quality measures. VBP refers to a set of performance-based payment strategies that link financial incentives to health care providers’ performance on a set of defined measures to achieve better value (Damberg et al., 2014). VBP program excludes some hospitals that do not have a minimum number of cases from participation, like psychiatric institutions, oncology centers, or pediatric facilities; and hospitals that do not participate in the Hospital Inpatient Quality Reporting Program (Whitman, 2016). This year, CMS announced several changes to VBP, introducing four domains on hospital scores, with patient and caregiver centered experience and care coordination; safety; efficiency and cost reduction, removed two measures from clinical care and added a care transition dimension (Whitman, 2016).
Past decade has been a one big experiment with pay-for- performance payment systems, primarily with P4P. However, we still know very little about how to design and implement VBP programs to achieve stated goals and what constitutes as a successful program (Damberg et al., 2014). As of today, hospitals are assessed based on comparison to its peers and its own performance over time. According to research, about 1,600 hospitals will see bonuses from Medicare in 2017 under VBP (Whitman, 2016). The lowest performing hospitals will see a reduction in DRG payments of 1.83%, and the highest performing hospitals will see an increase of more than 4% (Whitman, 2016). Compering numbers of hospitals from 2016 to 2017, numbers of hospitals that payments were deducted grew from 1,236 to 1,343, accordingly (Whitman, 2016). According to researchers and critiques of VBP, this design has a flow, as it set up as a tournament style, in which hospitals are stacked up against each other, and really do not know how they perform until very end (Whitman, 2016). With this year’s changes in major domains on which hospitals are scored, we will gain new perspective on how progress on quality can be accelerated when pay-for-performance programs reward both achievement and improvement (Whitman, 2016).
Since we are discussing pay for performance programs, I thought it was fitting to talk about earthly rewards. In the bible there is a scripture that says, “whatever you do, work heartily, as for the Lord and not for men, knowing that from the Lord you will receive the inheritance as your reward. You are serving the Lord Christ” (Colossians 3:23-24, NIV). Everything that we do as healthcare administrators we should look at it as a service to the Lord. We should do it gladly and to the upmost of our ability. We are his servants as we do his will on earth the reward is the individual that we bring to Christ just based on our day to day operations. The pay for performance program is set up the same way as the bonus or reward is based on exceeding the quality standard that is set.
Reference
Damberg, C., Sorbero, M., Lovejoy, S., Martsolf, G., & Mandel, D. (2014). Measuring
success in health care value-based purchasing programs: Findings from an environmental scan, literature review, and expert panel discussion. RAND Health Quarterly. Vol. 4, No. 3. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC51613…
Harrington, M. (2016). Health care finance and the mechanics of insurance and reimbursement.
J&B Learning.
Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st
century. National Academies Archives. Retrieved from: http://www.nationalacademies.org/hmd/~/media/Files…
Mendelson, A., Kondo, K., Damberg, C., Low, A., & Kansagara, D. (2017). The effect of P4P
on health, health care use, and process of care: A systematic review. Annals of Internal Medicine. Retrieved from: http://annals.org/aim/fullarticle/2596395/effects-…
Warner, R., Kolstad, J., Stuart, E., & Polsky, D. (2011). The effect of P4P in hospitals: Lessons
for quality improvement. Health Affairs. Vol. 30, No. 4. Retrieved from: https://www.healthaffairs.org/doi/full/10.1377/hlt…
Whitman, E. (2016). Fewer hospitals earn Medicare bonuses under value-based purchasing.
Modern Healthcare. Retrieved from: http://www.modernhealthcare.com/article/20161101/N…
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Responding back to feedback
/in Uncategorized /by JosephTo prepare for this Assignment:
The Assignment:
Revise the three paragraphs from the Week 5 Assignment, addressing relevant feedback from your Instructor. You may also add new content to your paragraphs. However, you should not use any other sources beyond your chosen article.
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GCU Shattuck Lecture: A Successful and Sustainable Health System
/in Uncategorized /by JosephThe author of the assigned article, “Shattuck Lecture: A Successful and Sustainable Health System — How to Get There From Here”
(https://lopes.idm.oclc.org/login?url=https://search-proquest-com.lopes.idm.oclc.org/docview/929159711?accountid=7374) maintains that a sustainable health system has three key attributes. What are these three key attributes and what recommendations are offered to ensure efficiency, sustainability, and optimal functioning?
PLEASE USE THIS ARTICLE AND CITE IT FOR THE QUESTIONS ASKED. IF YOU WANT TO ADD MORE THAT’S FINE BUT USE THIS ARTICLE FIRST. ALL THE QUESTIONS ARE IN THE ARTICLE. THANKS.
I WILL SEND THE REPLIES FOR CLASSMATES TOMORROW.
ALL THE QUESTIONS ARE IN THE ARTICLE.
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History of Autism Spectrum Disorder (ASD) Science Assignment Help
/in Uncategorized /by JosephPlease answer in a complete sentence the questions/statements below for chapters 10. When answering, please number your answers.
Chapter 10
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low birth weight
/in Uncategorized /by JosephDescribe the effect of extremely low birth weight babies on the family and community. Consider short-term and long-term impacts, socioeconomic implications, the need for ongoing care, and comorbidities associated with prematurity. Explain how disparities relative to ethnic and cultural groups may contribute to low birth weight babies. Identify one support service within your community to assist with preterm infants and their families and explain how the service adequately addresses the needs of the community, or a population in your community. Provide the link to the resource in your post.
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HSA315 Strayer Competitiveness and Performance for Health Care IT Systems
/in Uncategorized /by JosephWrite a six to eight (6–8) page paper in which you:
Your assignment must follow these formatting guidelines:
The specific course learning outcomes associated with this assignment are:
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A Self-Analysis On Personal Charactor Essay Help
/in Uncategorized /by JosephFor this first essay I am asking you to write a self-analysis in which you analyze your own identity using the concepts from the texts that we’ve read so far. I would like you to examine your own experiences in two different contexts (e.g.who you are as a family member vs who you are as a student) in relation to your most salient identities (gender, sexuality, race, language, social class, etc)
Your essay should be at least 1200 words, double spaced, in 12 point font with 1 inch margins.
Your essay must use concepts and terms from at least two of our class readings in your analysis.
Your essay must be organized in paragraphs around a thesis or main idea that develops throughout the whole essay.
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Political & Business
/in Uncategorized /by Joseph1. What type of an economic system does China have? Do they have have a capitalist economy or a socialist economy? How will this influence the way US businesses operate in that country?
2 Is the political and business landscape favorable for doing business in China? What do you think will be the biggest challenges for US wanting to do business in China? http://www.doingbusiness.org/en/rankings
Please use the questions as your headings. Use the APA style with in-text citations. Please keep your paragraphs short (paragraphs that are more than half a page is to be avoided)
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Case Report 3
/in Uncategorized /by JosephYou will be creating a case report in stages over four course topics. This assignment will add to your previous work in Topic 3. Use an example from your own personal practice, experience, or own personal/family; however, simulated cases are not acceptable for practice hours and therefore not acceptable for this assignment. Examples might include a patient with Duchesne’s muscular dystrophy. Huntington’s disease, Down’s syndrome, sickle cell anemia, BRCA 1 or BRCA 2 mutations, or other genetic disorder that you and/or the organization you practice in may specialize in treating.
General Requirements:
Use the following information to ensure successful completion of the assignment:
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
This assignment requires that at least two additional scholarly research sources related to this topic, and at least one in-text citation from each source be included.
You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.
Directions:
For this assignment (Part 3 of the Case Report), write a 1,000-1,250 word paper incorporating genetics information learned from assigned readings in Topics 1-5: Genetics, Family History, Pharmacological Component, Nutrition. Include the following:
1.Examine how genetics can influence policy issues.
2.Discuss any nutritional influences for the cause of this disease.
3.Discuss the process of nutritional assessment and counseling as it relates to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness.
4.Discuss the prevalence rates, testing, treatment, and prognosis as they relate to human nutrition.
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