1 Discuss the potential and possibilities for increasing rev

1. Discuss the potential and possibilities for increasing revenue, reducing costs, effectively managing cash flow or increasing reimbursement for providers in the light of the recent 2. Share your insight on innovative provider payment methods that have or are expected to alter the nature of medical care industry radically on its financial side. Students are asked to (2.1) identify the characteristics of the payment system, and strategies payers and providers use to reduce their financial risk (payment system and pricing strategies) and (2.2) to discuss the

Solution

Both concepts are answered in line with health care regulation in USA.

Answer 1)

A repeal of the current Affordable Care Act (ACA) are closer, so revenue cycle management becomes very important than ever in 2017.With high level of uncertainty over the replacement the ACA, citizens afraid about the chances of losing health care coverage and to pay medical bills out-of-pocket. Even for the isurance providers, this can result in lose in profit due to unpaid accounts receivable (A/R).

Along with the above hospitals, medical groups,  physician practices, and health systems have to lose huge cash flows due to implimentation of the new payment model. Many health systems and hospitals are already having very tight funds flow situation due to rising day today operational costs, and mounting competition.

The modern approach of management of revenue cycle is a critical process that should be managed properly and tracked carefully. Revenue cycle consists of “administrative and clinical fucnction for collection of service revenue,” as per the Healthcare Financial Management Association.

A simple error in the cycle badly impact the cash flow of health care entities. The data captured through this revenue cycle imangement system is also used for reporting to federal and state oversight organizations.

The modern appoaches use to Improve Revenue Cycle Management

There is a list of five modern steps that an organization can take to improve revenue cycle as well as increase in cash flow:

decission on the collection time directly depend on:

Answer 2)

2.1)The financial risk involved in any payment system have very importnat role in success , in case of health care system , some major characteristics of payment system and strategy payers and providers use to reduce financial risk can be as below.

And many more

2.2 ) To get better value for any dollar made in health care insurance, significant discussion has emerged on the methods to align economic and health incentives to achieve predecided goals.

Some major strategies as new wave system in health care are given below.

Episode-of-Care Payment strategy for reduction in Inefficiency and leakages :the system explains a single amount to cover all of the services given to a patient during a single episode of care

A Value-Based Payment System : In the system the payment is decided by exclusive methods , as need of every one is different from each others.

Health Insurance Exchange / plateform : a powerful process to lower down the cost of healthcare services and improving healthcare quality. As the health care provider can bid for serives and user have right to select the cheapest one.

Value-based insurance design : A good practice to share incentives for patients based on the evidence-based value of specific services.