Please answer questions thoroughly and completely with vocabulary and concepts.
HEALTH CARE VALUE
What is health care value and why are there differing opinions about that definition?
COST DRIVERS AND BARRIERS TO HEALTH CARE VALUE
There are six cost drivers and barriers to health care value. Please discuss the pros and cons of each of them briefly:
1. Fee-for-Service (FFS) Payment Models
2. Failure of Care Delivery
3. Failure of Care Coordination
5. Administrative Complexity and Fraud
6. Pricing Failures
INITIATIVES TO ADDRESS EXPENDITURE/VALUE TRADEOFFS
Although Value-Based Payment Models sounds like $$$ in your pocket and improved quality, it is generally more of the same in a different package. All value-based care models have three goals – how
1. to improve the patient experience,
2. to improve the health of populations, and
3. to reduce costs.
Please explain how bundled payments meets the above three goals, and how Medicare Access and CHIP Reauthorization Act (MACRA) utilizes two reimbursement tracks for those participating in a a value-based care model.
CASE STUDY: DELIVERY SYSTEM REFORM
Some efforts to meet the Triple Aim are related to how services are priced and how care is delivered. Please compare the approaches of
1. Patient-Centered Medical Homes (PCMH)
2. Accountable Care Organizations (ACO)
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