Compare MCOs, ACOs, and BPCIs with the initial FFS health insurance reimbursement programs. How does each control or reduce costs? How does each address issues with over and underutilization
1) Compare MCOs, ACOs, and BPCIs with the initial FFS health insurance reimbursement programs.
How does each control or reduce costs?
How does each address issues with over and underutilization?
How does each deal with quality of care?
How does each deal with continuum of care?
2) Which of the health insurance reimbursement methods (FFS, MCOs, ACOs, and BPCIs) are better for patients? Insurers? Providers? Support your response with scholarly resources.
3) Scenario 1: As a rehabilitation director in a nursing home. Your administrator has given you the directive that to participate with a Medicare MCO and become a preferred provider for a hospital BPCI or comprehensive care for joint replacement (CJR) program, you need to reduce the length of stay for the short-term rehab patients from 20 days to 10 days for DRG 470: Total knee replacement. To compound the problem, you see that the usual 400 total knee patients you get annually has been reduced to 160 patients. Consider measures you might recommend, e.g., consider length of stay, reducing readmissions, attracting new business, care redesign, patient satisfaction, and physician engagement.
Provide a redesign strategy recommend for this scenario. Some redesign strategies might be considered are included with the scenario, but you are not limited by them.
Justify why it was selected the redesign strategy and how to implement it.
Be specific and provide an example.
Locate a scholarly article to support the redesign strategy and give a brief summary of the outcomes or results of the implementation of the strategy.
4)
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