Pros and Cons of The Reimbursement Method Discussion

Pros and Cons of The Reimbursement Method Discussion ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Pros and Cons of The Reimbursement Method Discussion “The complexity of financing in health care is one of the primary characteristics of medical care delivery in the United States” (Shi & Singh, 2012, p. 129). There are numerous reimbursement methods (e.g., capitation, fee-for-service, package pricing, etc.) that are used by health care organizations and providers to get paid for the health care services that they provide. Building upon your Individual Project from Unit 1, write a 3-5 page paper not including a title page and reference page that contains the following: Pros and Cons of The Reimbursement Method Discussion Summarize 3 different reimbursement methods that are used by health care providers and organizations. Choose which method(s) will work best for the health care facility that you have proposed to be developed, and explain why you chose that method(s). Discuss the pros and cons of the reimbursement method(s) that you chose. Discuss the impact that the method(s) may have on the financial operations of the facility that you chose. Note: You should include a minimum of 3 references, properly cited in APA format. Assignment Objectives Analyze the various types of reimbursement received for healthcare services and the effect on the financial operations of a healthcare organization Pros and Cons of The Reimbursement Method Discussion Apply business principles to the management of the healthcare organization hss490_unit_1ip_amb Ambulatory Surgery Center (ASC) Misty Fresenburg Professor Wilson Unit 1 IP November 28,1979 The type of facility I am recommending is ambulatory surgery center (ASC). ASC facilities primarily deal with providing same-day surgical care such as preventive and diagnostic measures (Ambulatory Surgery Centers Association, 2008). The reason I propose ASC over other facilities is due to their ability to provide convenient alternative outpatient procedures hence transforming outpatient experience for millions of people across the country. ASC have maintained a strong track of care as well as positive patient outcomes that makes them very suitable choice. Further, the reason I opted for this facility is because it provides patients with surgeries at a significantly lower cost compared to hospitals. More importantly, ASC minimize the patient’s risk of exposure to infection a common phenomenon in hospitals since the patients who visit ASC do so for surgery and not to get treatment from diseases and sicknesses (Al-Amin & Housman, 2012). Hence, compared to other facilities such as hospitals, ASCs are more preferable as healthcare facilities transform from inpatient to outpatient care. Pros and Cons of The Reimbursement Method Discussion ASC are healthcare institutions where patients can undergo surgeries without the need for hospital admission. The services provided by ASC are cost-effective and provide patients with a more convenient environment that most hospitals can provide. Patients who opt for surgeries in ASC facilities are able to arrive on their scheduled day of the procedure, undergo the procedure in well-equipped operating room and are able to recover with the help of highly qualified nurses (Al-Amin & Housman, 2012). All of this is achieved without patients being admitted to a hospital. Regardless of their age, all patients are able to significantly benefit from the ASCs services. ASCs provide their services in diverse manner with some ASCs specializing in providing services in a given specialty like sports medicine and eye care whereas other offer surgeries in diverse range of specialties. Consequently, ASCs are progressively an outstanding option for managed care as a way of guaranteeing high-quality and effectual outpatient surgical care. While most surgeries continue to be performed in hospitals, these occurrence is estimated to change. For example, in 2005, 59% of total outpatient surgeries were conducted in hospitals whereas only 41% of the surgeries were performed in ASC. However, current statistics have approximated that the number is bound to change by 2020 whereby only 40% of total outpatient surgeries in the country will be conducted in hospitals (Ambulatory Surgery Centers Association, 2008). Notably, current research findings indicate that there are minimal chances of patients from ASC operations ending up in the emergency room or seeking hospital inpatient services. Further, the rates of infection in ASC has been approximated to be half that reported in hospitals. Patient satisfaction is ASC’s trademark. According to a survey on Medicare beneficiaries who had received ASC procedures by the US Department of Health and Human Services’ Office of the Inspector General, 98% of the individuals where contended with their surgical procedure, outcomes, as well as experience (Wiggins, Peterson & Moss, 2015). There are numerous reasons why patients and physicians opt for ASC surgical procedures including the profound professionalism, quality, and safety that is provided in ASC. Most of the medical staff in over 75% of ASCs across the country have a certified rate exceeding 90%. A report conducted in 2007 indicated that in the course of a three month duration, 71% of ASC did not experience any complication over 1,000 patient happenstances (Ambulatory Surgery Centers Association, 2008). On the other hand, 69% of these ASCs didn’t refer their patients to hospital inpatient care or the emergency department. Among 1,000 patients operated in ASC, over 90% of ASC experience three or less cases of infections per 1,000 patients operated. Remarkably, available studies indicate that the quality of care provided under ASC often equals or exceeds that provided under outpatient surgery care (Owens et al., 2014). There are also numerous other reasons people and physicians opt for ASC operations including reliable services as well as the convenience of their scheduling. For instance, close to a third of ASC facilities identify that over 90% of their surgical procedures begin within 7 minutes of the scheduled time of the surgery. The procedures procured by ASCs are diverse in nature. In overall, ASCs focus primarily on surgery that entails pain management as well as diagnostic surgery services. Currently, most knee, eye, spine, and shoulder among other surgeries are conducted by ASC. As of 2016, the three procedures commonly procured by ASCs were cataract surgery using intraocular lens insert, upper gastrointestinal endoscopy utilizing biopsy, as well as colonoscopy that integrated biopsy (Hollenbeck et al., 2015). In general, most of the services offered in ASC could be termed as procedures. The ASC will adopt a highly efficient staffing model when hiring clinical staff. The ASC facility staff and administrators will conduct both traditional as well as non-traditional responsibilities. Hence, the staff will have to put on many hats on a particular day. A registered nurse will entirely be responsible for the patient care in the facility. The RN must have a license provided after completing the National Council Licensure Examination for Registered Nurses in order to work at the facility. Two nurses will also be given the responsibility of infection prevention as well as monitoring the compliance of the facility to the infection control program. The nurses must complete a 2-year associate’s degree in nursing in order to become certified nurses. Pros and Cons of The Reimbursement Method Discussion The surgical technician will be responsible for arranging and organizing the operating room and making sure all the critical equipment are prepped and collected. Because of the nature of their jobs, the surgical technician will also fill the role of a materials coordinator with both organization and prioritization being critical in both job specifications. The surgical coordinator will be responsible for purchasing supplies, examining special orders, keeping record of purchases, receiving products, and being responsible for shipment received as a materials coordinator. Other team members will be tasked with assisting the surgical technician in restocking supply regions and receiving products. In order to qualify for the position, the surgical technician must have a certificate from a certified training program. A nurse manager will also be present at the ASC facility and will play both the roles of patient care as well as administration. The nurse manager will exercise managerial authority over the other clinical staff at the facility. The nurse manager must be an expert in both clinical duties including patient care as well as administrative duties such as staff management. The NM must be organized and able to tap from the assistance of the other staff members in order to achieve tasks. The facility will work with numerous physicians who will be responsible for procuring various surgical procedures. A safety officer will be responsible for helping with staff educating doing audits, as well as collecting items for meetings etc. An applicant must’ve completed postsecondary education and attained specialized training in order to qualify for the position. The physicians the ASC will work hand in hand with must possess training medical licenses. Ultimately, front office personnel are another important part of the ASC facility. These personnel are responsible for putting on numerous hats in a single day. They will be responsible for registration, reception, scheduling, medical records, patient collections, as well as verification and authorization of benefits. In other cases, they will help administrators with tasks such as personnel file maintenance, payroll, onboarding, as well as benefits administration. Due to the diversity of their profession, their unique skills shouldn’t be overlooked. The applicants will have to meet the following requirements to qualify for the position, completed a hospitality related course, successful work experience, well informed on office procedure and accounting principles, ability to maintain office equipment. Pros and Cons of The Reimbursement Method Discussion References Ambulatory Surgery Centers Association, (2008). What Are Ambulatory Surgery Centers? Retrieved from: https://www.inova.org/sites/default/files/Services/surgical_services/PDFs/ambulatory-surgery-centers-brochure.pdf Al-Amin, M., & Housman, M. (2012). Ambulatory surgery center and general hospital competition: entry decisions and strategic choices. Health care management review , 37 (3), 223-234. Hollenbeck, B. K., Dunn, R. L., Suskind, A. M., Strope, S. A., Zhang, Y., & Hollingsworth, J. M. (2015). Ambulatory surgery centers and their intended effects on outpatient surgery. Health services research , 50 (5), 1491-1507. Owens, P. L., Barrett, M. L., Raetzman, S., Maggard-Gibbons, M., & Steiner, C. A. (2014). Surgical site infections following ambulatory surgery procedures. Jama , 311 (7), 709-716. Wiggins, C., Peterson, T., & Moss, C. (2015). Ambulatory surgery centers? use of Health Information Technology. Health Policy and Technology , 4 (2), 100-106. Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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