Question

Option 1: Briefly discuss one of the following changes that are impacting healthcare quality and reimbursement today:

• The Patient Protection and Affordable Care Act (PPACA)
• The Prospective Payment System and development of diagnosis-related groups (DRGs)
• Shift from third party, fee-for-service plans to capitated managed care programs
• Shift of government and private insurer reimbursement from volume to value based reimbursement.

Option 2: Briefly discuss one of the following sets of budget concepts:

• Personnel, operating and capital budgets
• Fixed/variable, controllable/non-controllable costs for healthcare organizations
• Budgeting methods (incremental, zero-based, flexible, performance-based)
• HMOs, PPOs
• Use of critical pathways

Answer 1

Answer ACA man furpose to loweY hoalth care tost over timeThere are many advantages o conclude that it is a ACA Which can idea as The major benafit o ACA is that it lowers the rise t health Care Coct. leople treatment beforethey need emergen y can &recieve oom services all insurane plon to over essential Ot coves mosty health benefitsThese includes reatment of mental health addiction, and Chronic diteases o Snsurane ompany cannot coverage lor pre-xicting Conditions oeny anyone

Answes HMO's (Health Mavictanan e Organieation) ma It s a that wuag lon corer the Care trom doctors who work for type o health insurance or Lontract oth the HMO. These plans are loast expensive and hare more Loverage opteons fongonerds Share ofayment given to a the othor providers Co s dlone as 8ome of the thyorcan PPo CPoefered Provider Organization) foliy This plan Lons is ts of to ofhon comparer more as HMO, compared to HMO This is costly as 6 Fee for-Service Poliy This service is mast expensive than anyother policy and because of th it sbecoming lessfopulor Here bills can be paid to the cloctor and then the paper hoork howed deiedly to the tnsurer to eimbursed for the faynient

Advan tage of HMo An HMO has a lorge nehwonk. Hashitals and Clinics affiliated Noith HMOS are in ce it usually involves accreditation that is fitered by a vey competitive HMOS Set gualiticaton 2 An HM0 is less costly than Mast mdical plans Mast of the hreatmen t that ete 77pi cauly do oi thin the HMD nehook are dependen't on maximum Benefit Limit