PROVIDE A RESPONSE OR STATEMENT TO THIS STUDENTS DISCUSSION: What kind of paymen
ID: 123593 • Letter: P
Question
PROVIDE A RESPONSE OR STATEMENT TO THIS STUDENTS DISCUSSION:
What kind of payment method is more suitable for reimbursing PCMH? Please justify your answer.
Research confirms that medical homes can lead to higher quality and lower costs, and can improve patient and provider experiences of care. Is this a reality or not? Validate your answer with examples.
How is this program implemented?
I believe the payment method more suitable for reimbursing the PCMH is per-member-per-month (PMPM) with pay-for-performance (P4P) payments (Basu, Phillips, Song, Landon, & Bitton, 2016) incorporated into an ACO. This type of payment method allows PCMH providers to be in charge of managing the patient’s medical care based on each patient’s specific needs. It doesn’t link payment to the number of visits made, like fee-for-service does. Physicians need the freedom to customize care but also need to be accountable for their decisions. The PMPM guarantees a certain level of revenue that PCMHs need to pay their operating expense. The P4P option incentivizes physicians/staff to tap into creative ways to exceed quality goals and provides additional revenue to fund these new initiatives. The fact that it is part of an ACO means it has access to more acute levels of patient care, but encourages providers to prevent advancement when possible.
It is a reality that medical homes can lead to higher quality and lower costs, while improving patient and provider experiences related to care. Medical homes provide continuity of care. All of the services a patient might need are located under one roof, which makes it easy and convenient for the patient. Providers there develop relationships with patients, which is so important for building trust. Providers need for patients to be truthful about what REALLY happens at home. They need to know if they are not taking their medications as prescribed and what barriers are preventing this from happening. They need to know if their A1C is staying elevated because they are drinking regular soda all day. They need to know if they are trying to make their medication stretch because they can’t afford to buy it every month. Or maybe they’re accidentally taking their water pill instead of their diabetes pill because they only have one light in the house and it’s in a different room from where they take their meds. All of these issues are very intimate and patients are ashamed to speak up about them. However, when they feel their physician is their doctor AND their friend, they are more likely to explain the real problems, which gives the provider the opportunity to intervene by connecting them to resources to eliminate the barrier. Not only does this improve patient satisfaction and outcomes, but it improves physician satisfaction because they are able to really make a difference. It increases quality and safety for the patient and lowers long term medical costs.
This type of program is implemented by restructuring offices to consist of interdisciplinary teams that include services like case management, community service workers, wellness coaches, dental services, nutritionists, laboratory, psychiatric and pharmacy services working together and getting paid for keeping people as healthy as possible. As a result, chronic diseases are managed better, patients are healthier, and there is less healthcare related spending.
Explanation / Answer
The answer they provided covers the info but the order they mentions is not so clear. First you should understand the question answe the same one by one.
In firt question they asked about suitable payment methods to reimburse PCMH, there you mentioned is not that so appropriate but you coverd the info in first aragraph of next answer.....how to be implemented.
you need to mention what is PCMH, what is the benefit of PCMH, and payment methods like per-member-per-month (PMPM) with pay-for-performance (P4P) payments.
In the second question again you need make it a bit clear but info provided is appreciated. last paragraph should come first and then should explain how the way of imlecation is going to be so effective in providing quality care at less cost.
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