Question

Please type out the answer: Discuss how reimbursement methodologies impact the operations of healthcare organizations, particularly around the dimensions of access, cost, and quality. What about distribution of wealth? Should those who have more money have more access to a higher quality of health?

Answer 1

Reimbursement

Reimbursement means the act of compensating someone for an expense.

Reimbursement methodologies and Health care organizations

Reimbursement systems allows the health care providers to get their incentives and it may motivate physician. There are various methodologies for reimbursement in health care sector. They are Fee-for service( also known am volume based reimbursement, here specific fixed fee for each procedures and additional cost- control components have been included).

Value based reimbursement ( It is a new model. Reimbursement is based on the quality and efficiency of care or services provided). It rewards health care providers for supplying quality care to patients. Health Care providers have to aim at providing quality care and wellbeing for population at lower cost.

Discount from Billed charges

This gives the lesser level of risk for providers, here payer agrees to reimburse . But in this system payers often scrutinise the bill and there can be higher rejection rate which can lead to additional audit.

Bundled payments

Health care providers can be reimbursed for a particular episodes of care with this system. This method promotes greater coordination of care and it also prevents medically unnecessary services.

Distribution of wealth

Health of the people with low income often in struggle as their financial capacity is inadequate for meeting the needs for treatment services. Health and wealth inequality exists today. Those who have more money have more access to high quality of health care as the fee - for-service system is more prevalent in the Country. Specialists are demanding more fee than general physician. The present reimbursement system has to be changed . Everyone should get health care services equally independent of their income.