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Unit 2 Discussion: Payment Models

Estimated time to complete: 2 hours

Please complete the following steps for your discussion post and response.

How should physicians be reimbursed for the care they provide? This highly-debated topic can be answered in a variety of ways, and no one answer fits all practice settings. Let’s take a deeper dive into this topic and investigate the financial impact of using productivity, quality, and financial measures to create a reimbursement structure.

A large family practice group is meeting to discuss restructuring their payment model. The practice has four physicians, each with a different patient population:

• Dr. Andrews: large pediatric patient base, full-spectrum obstetrics/gynecology
• Dr. Brown: geriatrics, disease management
• Dr. Cascara: general family practice, cosmetic laser procedures
• Dr. Dole: general family practice, low-risk obstetrics/gynecology

As the clinic manager, you play an active role in the daily implementation of managing the patient populations and ensuring accurate reimbursement is processed. The practice manager, Jane, has asked to meet with you to hear your thoughts on restructuring the physician payment model.

• Compare and contrast the impact of using productivity measures among the four physicians. Briefly explaining which productivity measures could benefit each physician, and why.
• Discuss how quality measures could be used to determine reimbursement. Which physicians would this currently benefit? Which might struggle in this area, and why? (Note: you will need to assume fictional information to form this response).

Please be sure to validate your opinions and ideas with citations and references in APA format.

Please review post and response expectations. Please review the rubric to ensure that your response meets criteria.

Cite any resources/references in APA formatting that were used in the discussion – if applicable.

Peer Responses/Participation

Please post 2 peer responses.

In the response post, include the following:

Assume the role of Jane, the practice manager. Respond to your classmate/clinic manager.

• Based on the information provided by your clinic manager, describe the payment model you believe would benefit all parties involved (including the overall profitability of the practice).
• If you disagree with the clinic manager, be sure to specifically say why, and provide an alternative solution.

Please be sure to validate your opinions and ideas with citations and references in APA format.

Please review post and response expectations. Please review the rubric to ensure that your response meets criteria.