Assess the extent to which healthcare organizations utilize financial management principles for guiding strategic planningAnalyze federal, state, andthird-party payer healthcare regulations and reporting guidelines for ensuring compliance with healthcare reimbursement requirementsRecommend collaborative teamwork principles for improving strategic planning processes involving healthcare reimbursementSuggest financial approaches for improving cash flow, days in accounts receivable,and timeliness of reimbursements from various healthcare payer modelsRecommend strategies for maximizing healthcare reimbursement by reviewing the impact of case rates and management utilization data on pay-for-performance incentivesPromptYour analysis with recommendations should answer the following big-picture questions: What reimbursement payment methods and strategies are associated with the healthcare industry? How do financialmanagement principles relate to reimbursement in evaluating operational performance? And, how does the revenue cycle affect various departments within the healthcare organization?
Specifically,the following critical elementsmust be addressed:I.Introduction: What is the purpose, scope, and subject of your analysis and management report?Your introduction must describe the aim of your paper, what you are assessing, and the analysis you expect to perform.II.Financial Principles and Reimbursement:a)ReimbursementStrategies: What is the impact of case rates and management utilization data on pay-for-performance incentives? Be sure to provide support for your response.b)ReimbursementMethods: Analyze reimbursement methods, describing the advantages and disadvantages of each method in terms of strategic planning for operational performance. For example, why might one method be more advantageous than another at a hospital or at a physician’s office?c)Financial Management Principles: Compare and contrast financial management principles such as financial data that describe financial performance of revenue reimbursement, benchmarking of industry standards, payer-mix breakdown of payers, and case rate and utilization rate data used to evaluate operational performance. d)Accounts Receivable: What are the challenges associated with collecting payments for the accounts receivable or collections department, and whatis the significance of monitoring cash flow and days in accounts receivable in terms of reimbursement?e)TeamworkPrinciples: Compare and contrast collaborative teamwork principles to most effectively develop strategic planning that involves cross-disciplinary teams. In other words, what principles work best for teams where individuals are from both clinical and non-clinical departments? What are some of the challenges this might present for cohesive collaboration? Be sure to providesupport for your response.f)Maximizing Reimbursement: Generally speaking, to what extent do you feel healthcare organizations utilize case rates and management utilization to maximize reimbursement from both government and third-party payer payment systems? Be sure to provide support for your response.III.Federal and StatePaymentSystems:a)Federal and StateRegulations: Considering the recent changes in economic policy at the federal and state levels, what changes in federal and state regulations present the most concern for healthcare leaders? Be sure to providesupport for your response.b)Reporting Requirements: Analyze the reporting guidelines required by Medicaid and Medicare and other government payment systems. What are the opportunities and challenges for healthcare leaders in meeting reporting requirements?c)ComplianceStandards andFinancialPrinciples: Analyze how healthcare organizations in general utilize financial principles to ensure compliance with government standards.d)Government Payer Types: Considering Medicaid, Medicare,and other government payer systems, what strategies would you recommend organizations implement in order to receive full reimbursement on claims as well as to improve timeliness of this reimbursement? Be sure to justify your recommendations.IV.Third-Party Payment Systems:a)HealthcareSystemReimbursement: Evaluate third-party payer models for the impactsthey present on healthcaresystem reimbursement.
