Reimbursement Methods

Part 2: The Cost of the U.S. Health Care System Describe three different reimbursement methods (e.g., capitation, fee-for-service [FFS], pay-for-performance [P4P], value-based, episode of care, prospective reimbursement, diagnosis related group [DRG], patient-centered medical home [PCMH]). Explain why you think one of the reimbursement methods you discussed is more effective at reducing health care costs overall while still ensuring the delivery of quality care. Describe the use of two technological advancements (e.g., electronic medical record [EMRs], electronic health records [EHRs], medical research, improved equipment like magnetic resonance imaging [MRI], mammography, personalized medicine, mobile services like e-prescribing, disease registries, ). Explain why you think these advancements have reduced costs overall while still ensuring the delivery of quality care. Part 3: The United States Versus Other Health Care Systems: An International Perspective Contrast the S. health care system with another country (e.g., Canada’s universal health care or South Africa compared with the U.S. health care system, etc.). You can use the same country discussed in the Week 4 Health Care Systems Around the World discussion. Discuss how the other country’s health care system is funded. Discuss disparities in health care from your chosen country. Include at least one positive aspect from the other country’s health care system that you would like to see added to the S. health care system, explaining why you would like this addition. Part 4: Reforms and Improvements Describe two potential reforms and improvements currently being debated at either the local, state, or federal You may want to review the Laws and Regulations Affecting Health Care discussion prompt to help you with this component. Examples could include any of the following: Federal modifications (e.g., antitrust reforms, CHIP, HSA or HRA, Medicare reform, Medicaid expansion, PPACA repeal, pharmaceutical regulations, development of a universal system, veterans’ health care, crossing borders for health care, clinical trial research, ) State modifications (e.g., Medicaid reform, income tax credits, adoption of state level universal health care, etc.) Increased consumer controls (e.g., patient-centered care, provider choice, complementary and alternative care choices, activism for changes at the state and federal level, etc.) Reimbursement changes (Medicare, Medicaid, managed care plans, traditional insurance plans, etc.) Part 5: Conclusion: The Future of the U.S. Health Care System Examine what you believe the S. health care system will resemble in the next 10 years by recommending two changes and addressing access to care, quality of care, and cost of care, including an example of each in your vision of the future health care system.

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