Value based purchasing is a payment model that offers financial incentives to healthcare providers and organizations when they meet certain performance measures. This model also penalizes healthcare providers for poor outcomes, medical errors, or increased costs. Managed Care Organizations (MCOs), Accountable Care Organizations (ACOs), and Bundled Payment Care Improvement (BPCI Advanced) are prospective value-based purchasing programs aimed at improving healthcare quality and reducing costs. Hospitals and physicians participate in these programs with the goal of getting the right care to the right patient at the right time. In this Discussion, you will consider what happens with these systems as they relate to nursing home care. Nursing home administrators are facing a reduction in the demand for skilled nursing rehabilitation (SNF) beds, while physicians in an ACO or a gain-sharer in a BPCI program are looking at discharging patients with home care or outpatient resources to reduce cost. All these programs are affected by re-admission penalties. Most businesses are constantly looking to reduce cost. In healthcare, often the necessity to reduce cost means a reduction in utilization. Consider how this compares to a retail market where reduced demand reduces cost by consumer choice. How much influence does the consumer have on the change in healthcare economics? Is it the payer (Medicare), the provider (the physician), or the patient? Consider the following scenarios: Scenario 1: Scenario 2: Post a comprehensive response to the following:
Order an Essay Now & Get These Features For Free:
Turnitin Report
Formatting
Title Page
Citation
Outline
