Impact of Third Party Payor in Healthcare Systems
Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages to Order 5-10 Pages
Impact of Third Party Payor in Healthcare Systems
Healthcare System Reimbursement
This section is no longer than a half-page. Choose a third-party payor (Aetna, Blue Cross, Kaiser Permananete are all big ones). Identify two impacts a third-party payor has on a healthcare organization. (Why should the healthcare organization care about meeting the requirements of the third-party payor?)
This section is no longer than a page. Using the same payor, what are some items that are required to be reported to that payor? What are two opportunities (benefits for the healthcare organization and/or American health) and two challenges (concerns within the healthcare facility) for healthcare leaders in meeting the reporting requirements you described?
This section is no longer than a half-page. Return to your Financial Management Principles section on part one of this project. Look more closely at two of those principles and expand upon how those principles ensure compliance with your third-party payor standards.
This section is no longer than a half-page. Identify two strategies you would recommend organizations implement to receive full and timely reimbursement on claims from your third-party payor.
Part 4: Operational and Strategic Planning in Healthcare
This section is no longer than a half-page. What are two operational recommendations you would make to improve performance measures so your organization can maximize reimbursement? Please explain how these two recommendations will help to improve performance measures.
Operational Performance Measures
This section is no longer than a half-page. What are two performance measures that should be benchmarked so reimbursement is maximized? Why?
Teamwork and Strategic Planning
Use the chart below for this section. Please select two techniques.
Collaborative Teamwork Technique How It Will Help Maximize Reimbursement
Communicating Strategic Planning Across Teams
This section is no longer than a half-page. Identify and explain two methods you would use to communicate information to key stakeholders. For example, how would you communicate the same decision to patients, administrative staff, and clinicians?
Financial and Reimbursement Strategies
Use the chart below for this section.
++++++++++++ Cash Flow Days in Accounts Receivable Recommendation for Low Performing System What should the system do to improve cash flow? What should the system do to improve Days in A/R? Recommendation for High Performing System What should the system do to improve cash flow? What should the system do to improve Days in A/R?
Per APA requirements, references are written in alphabetical order. Only the first line of each reference is indented. See the course for more on how to write references in APA.
You will want to update this page with every milestone
Overview: Hospital administrators review accounts receivable schedules and reports to determine how much revenue is being received from various sources (i.e., Medicaid, Medicare, Anthem, self-pay from patients, and other third-party payers). Revenue from various sources is referred to as the organization’s “payer mix.” In this milestone, you will examine operational and
strategic planning in healthcare and consider selecting the three elements that you feel will be most important to complete in terms of receiving feedback.
Prompt: Submit a draft of the Third-Party Payment Systems and the Operational and Strategic Planning in Healthcare portions of your research and analysis.
Specifically, the following critical elements must be addressed:
- Third-Party Payment Systems:
- a) Healthcare System Reimbursement: Evaluate third-party payer models for the impacts they present on healthcare system reimbursement.
- b) Reporting Requirements: Analyze the reporting guidelines of third-party payer payment systems. What opportunities and challenges do they present for healthcare leaders in meeting reporting requirements?
- c) Compliance Standards and Financial Principles: Analyze how healthcare organizations in general utilize financial principles to guide strategic planning to ensure the meeting of third-party submission requirements.
- d) Reimbursement Methods: Considering third-party payer systems, what strategies would you recommend organizations implement in order to receive full reimbursement on claims as well as to improve timeliness of this reimbursement? Be sure to justify your recommendations.
- Operational and Strategic Planning in Healthcare:
- a) Pay-For-Performance Incentives: Based on your prior analysis of the impact of case rates and management utilization data on pay-for performance incentives, recommend appropriate operational strategies to improve performance measures that will maximize reimbursement.
Be sure to provide support for your recommendations.
- b) Operational Performance Measures: Considering benchmarking data, recommend performance measures that should be monitored for the purpose of maximizing reimbursement.
- c) Teamwork and Strategic Planning: Recommend collaborative teamwork principles that would be beneficial for healthcare strategic planning in terms of reimbursement. Be sure to provide support for your recommendations.
- d) Communicating Strategic Planning Across Teams: What types of tools or strategies would you recommend for communicating strategic planning conclusions to key stakeholders, members of cross-disciplinary teams, and the rest of the organization? In other words, how would you communicate strategic planning information to clinical vs. non-clinical staff? To administrative staff? Be sure to provide support for your recommendations.
- e) Financial and Reimbursement Strategies: Considering cash flow and days in accounts receivable for hospital and health systems, recommend reimbursement strategies that would be appropriate for low- and high-performing health systems. Provide evidence to support your conclusion.
Guidelines for Submission: Your draft of the third-party payment systems and the operational and strategic planning in healthcare portions of your research and analysis should be 2–3 pages in length and should be double-spaced in 12-point Times New Roman font with one-inch margins, in a single Microsoft Word document. All citations and references should be formatted according to current APA guidelines. Include at least two references. Use attached template.
Impact of Third Party Payor in Healthcare Systems
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points: Student failed to submit the final paper. 5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors 10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points: Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. They can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally, the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper.
GET THIS PROJECT NOW BY CLICKING ON THIS LINK TO PLACE THE ORDER
Do You Have Any Other Essay/Assignment/Class Project/Homework Related to this? Click Here Now [CLICK ME] and Have It Done by Our PhD Qualified Writers!!
Tired of getting an average grade in all your school assignments, projects, essays, and homework? Try us today for all your academic schoolwork needs. We are among the most trusted and recognized professional writing services in the market.
We provide unique, original and plagiarism-free high quality academic, homework, assignments and essay submissions for all our clients. At our company, we capitalize on producing A+ Grades for all our clients and also ensure that you have smooth academic progress in all your school term and semesters.
High-quality academic submissions, A 100% plagiarism-free submission, Meet even the most urgent deadlines, Provide our services to you at the most competitive rates in the market, Give you free revisions until you meet your desired grades and Provide you with 24/7 customer support service via calls or live chats.