Question

Discuss the evolution of a reimbursement methodology, legislation event, or a trend in the history of healthcare reimbursement.

Answer 1

Healthcare systems has three stake holders -a healthcare purchaser, a healthcare provider and a patient.The interaction between them is governed by the government.It is contractual in nature which is based on agreement wherein healthcare provider promises to deliver the service to the set of people being covered and inturn is reimbursed by the purchaser according to the conditions agreed.For example Medicare and Medicaid are federal agencies which pay for the services provided to elderly and disabled people and also people with low income group respectively.These value based reimbursement methods have a large impact on hospitals and their approches are also managed well.

Health analytics will play a critical role in the world of value based reimbursements .The effective value based reimbursement programs should require access to data and analytics to support measurement and also improving them.Many types of reimbursements words are present like retrospective payments,fee schedules,self pay,episode of care,fee for service,medpac etc which are included in reimbursement methodologies.