Instructions
There are other programs offered by the government that look to incentivize health care providers through demonstrating the delivery of quality health care and a commitment to quality patient outcomes. To encourage participation, incentives programs which support quality outcomes, have been established.
- Identify and describe the four incentive programs used to encourage providers to meet quality health care expectations.
- In your review, identify what the incentive program requires from the health care provider.
- Discuss the financial impact of each incentive program on the health care organization if the program is adopted.
Assignment Requirements
- Please complete all parts in a Microsoft Word document.
- Quoting should be less than 10% of the entire paper. Paraphrasing is necessary.
- You must cite and reference 1 additional credible source.
Expert Solution Preview
Introduction:
Incentive programs have been established by the government to encourage healthcare providers to deliver quality healthcare and improve patient outcomes. These programs offer financial benefits to healthcare organizations for meeting specific quality measures. The following questions require the identification and description of four incentive programs used to encourage healthcare providers to meet quality healthcare expectations, the requirements of each program, and the financial impact they have on healthcare organizations.
1. Identify and describe the four incentive programs used to encourage providers to meet quality healthcare expectations.
Answer: The four incentive programs used to encourage providers to meet quality healthcare expectations are the Hospital Value-Based Purchasing (VBP) Program, the Merit-based Incentive Payment System (MIPS), the Advanced Alternative Payment Models (APMs), and the Accountable Care Organizations (ACOs). The Hospital Value-Based Purchasing (VBP) Program rewards hospitals based on their quality of care and patient experiences. The Merit-based Incentive Payment System (MIPS) incentivizes healthcare providers to focus on quality, resource use, clinical practice improvement activities, and advancing care information. The Advanced Alternative Payment Models (APMs) program incentivizes higher-quality and more coordinated healthcare by encouraging the adoption of innovative payment models. Finally, the Accountable Care Organizations (ACOs) incentivize providers to work together to improve care coordination, reduce costs, and improve patient outcomes.
2. In your review, identify what the incentive program requires from the healthcare provider.
Answer: The incentive program requirements for healthcare providers vary among the incentive programs. For the Hospital Value-Based Purchasing (VBP) Program, healthcare providers need to meet specific quality measures and patient satisfaction scores to receive the incentive payment. For the Merit-based Incentive Payment System (MIPS), healthcare providers must report on quality performance, resource use, clinical practice improvement activities, and advancing care information to receive payment incentives. The Advanced Alternative Payment Models (APMs) require healthcare providers to take on financial risks for delivering high-quality and coordinated care, while the Accountable Care Organizations (ACOs) require providers to work together and share financial risks to improve care coordination, reduce costs, and improve patient outcomes.
3. Discuss the financial impact of each incentive program on the healthcare organization if the program is adopted.
Answer: The financial impact of each incentive program on the healthcare organization varies based on the program’s requirements and the healthcare organization’s performance. The Hospital Value-Based Purchasing (VBP) Program can have a significant financial impact on healthcare organizations, with maximum penalties of 2% and maximum rewards of 2.5% of Medicare payments. The Merit-based Incentive Payment System (MIPS) can also have a significant financial impact on healthcare providers, with penalties of up to 9% and rewards of up to 9% of Medicare payments. The Advanced Alternative Payment Models (APMs) can provide significant financial benefits to healthcare organizations by offering incentives for delivering high-quality, coordinated care while also taking on financial risks. The Accountable Care Organizations (ACOs) can also provide financial benefits by incentivizing providers to share risks and work together to improve care coordination and reduce healthcare costs.
