Question

What are the budgetary and financial implications of shared risk models on health care management practices and decisions.

Answer 1

The budgetary and financial implications of shared risk models on health care management practices and decisions are as below

• The budgetary and financial implication is that the share risk model will not allow them to cover the access cost incurred in the health management as per this risk model. Thus the health service provider needs to ensure that the cost of health care is within the target limits and budget does not cross the limit and if it crosses, then the shared risk model will not allow for over limit payment.
• This model work on managing the risk associated with budget and financials. So the budgetary and financial implications are that the budget will not be changed and it will be managed as per the shared risk model only. This model will provide the performance based incentives and non performance based incentives will not be allowed under this law. Hence all the incentives needs to be covered under performances only.
• The implications are that as per this model, the health care needs to be exercise as per rule, regulations, with due documentation that can be used for any cross references and its payment will be value based reimbursement. Thus the implication is that without value assessment, the reimbursement cannot be happen or released. So this needs to be executed with due care and appropriateness with meeting all the requirement as per this shared risk model.