You are the associate vice president for education and training for Bobcat Health, an academic medical center and health system. The vice president of medical affairs comes to you concerned about the viability of the school’s residency programs. Several of the residency site stakeholders are seeking clarification regarding new reimbursement models being used by the system and gaining clarity on the revenue cycle process in general. Prepare a white paper for the VP of Medical Affairs to share with the residency sites outlining the differences between the new reimbursement models and prior, traditional models for stakeholders. Support your research with at least five sources. The use of professional charts / graphs to make the reading more interesting and to reinforce written content is encouraged. Ensure that your content and information is professional and can be followed by an executive audience. In your response, include the following:
- Introduce and discuss the various reimbursement methods (e.g., capitated payments, fee-for-service, etc.) and include emerging models being introduced to the industry.
- In your review, compare and contrast the traditional and new models and explain the motivation / reasons for the emerging models. Finally, based on this evidence, describe what impact (if any) you perceive there would be on the cost, quality and access to patient care. Support your research with peer-reviewed sources and/or market data. The use of professional charts / graphs to reinforce written content is encouraged. Ensure that your content and information is professional and can be followed by an executive audience.
- Identify the various steps within the revenue cycle process, including admissions, case management, documentation, coding, billing, et cetera. For each step identified, provide the following:
- Purpose of the step identified.
- Responsible functions completed by individuals, such as coders, registration clerk, etc.
- Key components of the function, such as verifying insurance, financial counseling, or coding of documented services provided.
- Consequences of failure to properly conduct the function identified.
- Assess how the application of digital tools might improve revenue cycle process management and performance.
