Reimbursement and Pay for Service Essay Example for Free

Reimbursement and feed for Service EssayIntroductionIn this penning we get out discuss what pay for performance is and explain what the reimbursement accept is. In this paper it forget sight how the system figures out price reduction and the impact of the quality grapple patients receive.How does reimbursement and pay for performance affect the physicians? Does this affect us now and will it in the future? health c be has been changing dramatically because of history, political and social along with economical reasons. Reimbursement and pay for performance target and may even interpolate the quality of manage. Pay-for-performance because our current payment system we are using is non emphasizing burden premeditation for patients or consumers. Pay-for-Performance is payment used in the health apprehension it is and has been based off of clinical information. The supposition is to sponsor tie the payment to what and how well providers help the cost of health c are drop. The intent is for preventive care medicine to helping decrease and help with the management of chronic illness. (Pay-for-Performance Incentive Programs in Health Care ( N.D.) With in several months studies puzzle shown that the studies show that the pay for performance works and others that say it does not work. Effect of Pay-for-Performance on ReimbursementHere are some examples of pay for performance is Bridges of Excellent, which is a nonprofit organization health care course of study. Its major factor is patients with diabetes. They feel like over 60% of patients with diabetes dont get the proper treatment and care. The American Diabetes Association has standards and the Bridges to excellent architectural plan gives annual bonuses to physicians in specific areas such as Boston, Louisville and Cincinnati these cities could and submit meet the requirements of this health care plan. On this plan diabetic care calls for the patient universe compliant with care and me dications. In this plan the blood sugar adjudicate and kidney function and retinal exams would haveto be make on a consistent bases. In this plan compensation is up to and over $100.00 per patient for the providers that stick to the rules.Another plan is Anthem Indianapolis this plan started in 1999 that employed over 25 OBGYN providers in Ohio. This is the oldest plan within the US. This plan is done on and by patient satisfaction. Providers push generic drugs instead of name brand ones. Pay For PerformancePay for performance is a movement in health care field of operation.Providers under this arrangement are rewarded for shock pre-established target dates for specific health care functions or procedures. This is also known as P4P or value-based purchasing, this rewards physicians, clinics, and rehabilitation centers, Surgical clinics, hospitals, medical groups, and other healthcare providers. They are rewarded for meeting certain performance measures, as well as quality and e fficiency. (Wachter, Bob (2012) Pay for performance does things such as eliminating payments for negative consequences of care. Which can be medical errors from all health care providers. Errors have increased costs. With increase of seasoned old citizens and disability patients the high rising cost of health care has brought the P4P to the front of the line. Brought P4P to the forefront of health constitution discussions. There have been some studies done by several large healthcare systems. With this it has shown improvements with specific outcomes. A little efficiency has taken effect, but at no cost savings. How much are they sincerely saving because the cost of administrative services is still required. Explains how reimbursement is affected by the pay-for- performance approach.Within the demise decade or years the economy has had many people becomingunemployed and finding jobs at a lower pay rate as to where they cannot afford insurance because they are to high. With being done more people are applying for Medicaid and with all the seasoned senior citizens retiring and receiving Medicare these two insurances are already participating in this service. Majority of health care systems are participating. Many believethat for- profit and non-for-profit health care facilities believe in lower cost for providers that meet the standards of quality care.Care field. There is a perception that cost is driving up health care treatment. Cost reductions lowers cost of visits, emergence path visits, and urgent care visits. It also helps providers to promote preventive care to their patients. Making sure that all hospitals and providers are on the same scale of service. Preventive care helps prevent insurance premiums from rising at cost to the company and consumer.Effect of Pay-for-Performance health care Providers and their PatientsThis plan has the support of providers, hospitals and even patients. With this pay for providers must have and use good judgment for treatment and medication and test that maybe ran. The health care cannot be rated by race, ethnic background, or the patients social status. This plan should not judge by a patients location. This plan is and should be a relationship between patient and provider. The provider needs to understand the patients beliefs and it may help them to treat them and respond to certain myths and recommendations that the provider may suggest.Hospitala and providers and helat care workers are being encouraged to buy into the P4P by different agencies and tahe government. Individual health plans area chiming in also. It has pros and cons such as weakness that may or may not improve health care. It is work out to help lower or slow down ER visits and physicians visits. Now if the providers give quality and efficent care they would and could get financial rewards if patient care improves. P4P measures performance and policy set up for putting this service in action. Discusses the effects pay-for-per formance will have on the future of health careThe P4P effects that will be matchn in the future of health care is that the health care field will see it expand. Pay-for-Performance-defined a reimbursement service that will have links to payments for quality care, which will be an incentive to help improve health care quality of patients by physicians, and hospitals. In improving health care it is reckon to reduce the cost of It was expected that hospitals and providers would respond to P4P incentives.For future health care will based on quality health care and it will become a contract for reimbursement. Patients should feel like they have gotten thevalue of their money. One effect of future health care is those physicians and hospitals that dont participate will be at less to receive patients. Patients that have this health care plan will be more apt to seek physicians that participate. (Goldberg, L (2006) ConclusionPeople in the health care field are getting interested in the p ay for performance because the health care guidelines and regulations are changing in Medicaid, Medicare and private insurance. More hospitals and clinics and specialty facilities and rehab centers are loving receiving incentives for their participation and in the process they are saving cost to patients and insurance companies. P4P is working with insurance companies and providers for the quality of care for patients to be improved. Now managed care is now looking at pay for performance. Reimbursement being linked to pay for performance is like being paid to shop for the best bargain or the most person to fit your needs.