Medicare Reimbursement In Health Care

Superior Essays
Medicare Reimbursement
Medicare pays a fixed amount for the patient’s care every month to the hospitals and physicians offering Medicare Advantage Plans. Medicare reimbursement rates are set by federal legislation which manage how much a hospital or physician will receive from Medicare to provide a given medical service or supply. Consequently, hospitals and physicians are paid a fixed amount that is expected to cover the costs of care while treating a patient. Therefore, the hospitals and physicians must follow specific rules set by Medicare in order to receive reimbursement. Additionally, financial incentives are given to hospital and physicians that encourage cost-efficient managing of resources.
ACO Reimbursement
Since an Accountable
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Physicians who understand how to implement the new detailed practices and help patients manage their illness more efficiently, can help push the changeover more quickly. Furthermore, the physicians and nurses need to have an ability to proficiently help patients manage their own illness; which includes proper medication usage, and help patients navigate throughout the health care system. It is also crucial that all the health professionals recognize the importance of delivering care in a uniform fashion. Additionally, health care professionals need to be committed to following the specific guidelines in order to deliver consistent care to a large number of patients efficiently. There are new rules, new standards, new technologies, and new solutions to merge into the daily operations of a health care delivery system (Page, 2001). Therefore, hospital professionals and staff should constantly be educated on the changing guidelines. To do so, online training programs and on-site training should be used to train the healthcare staff on how to deliver care in the most effective and efficient ways, as well as train on how to improve patient care. Continuing education of the health care staff would help reduce treatments and managing …show more content…
According to Darzi (2014), the introduction of records sharing schemes is already transforming the medical landscape by reducing errors and improving care. Electronic health records are crucial because ACO’s mange the health of the patient, thus requiring patient care records on every patient in the system. Health information technology provides clinicians with accurate and complete information about a patient’s health and reduces the amount of paperwork for patient and physicians. Additionally, electronic records are an essential part of data recording for the physicians to see the past history of each patient. This would allow the health care staff to take data from all the sources and use it specifically to track and manage the patients. The use of electronic health records would allow healthcare staff to track and manage patients across the system. The patient’s health information will be documented in an electronic medical record to ensure all team members and specialist have appropriate access to the patient’s medical record. Therefore, keeping electronic health records on patients help the medical staff recognize gaps in care and help give the patient the care they need, when they need it. This can greatly reduce the likelihood of emergency room

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