Bundled Payment Structure versus Fee-for-Service Payment Structure

Published: 2021-07-20 06:00:06
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Category: Economics

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Current health care trends affecting the employerShifting from the fee for service healthcare provision to a more outcome-oriented approach in the bundled payment structure has had different effects on the personnel involved. The approach is designed to take care of the bills relating to medical care especially in cases where the patient receives multiple interventions for the same condition. The cost of covering a disease with multiple care needs in usually too much for the patient making it necessary to offer a platform with centralized payment from which the different caregivers can deduct payment for the services they offered. The approach is a relief for patients but maybe adding strain to the healthcare provider.The differences in the interventional procedures in different medical conditions make the current bundled payment care unsuitable for some patients. The only medical cases that can be adequately handled by the bundled payment structure include orthopedic surgery and cardiovascular conditions due to the presence of a sequential care pattern. Such care interventions are easy to handle in bundled payments since the different caregivers are in most cases in the same location. The lack of centralized care in some medical conditions with the intervention procedures being unique to all patients depending with the clinical presentation makes it hard to formulate the criteria for the division of income amongst the different players (Shih, 2015).The bundled payment might not adequately provide the layout for the division of returns amongst the caregivers. Lack of a well-defined criterion with which the revenue is divided amongst the professionals involved might lead to neglect of essential care in an effort to minimize the number of clinicians cashing in on the revenue. A delicate balance between bundled payment approach and fee for service approach is essential to maximize the clinical outcome while still achieving both patient and professional satisfaction (Calsyn, 2014). Current health care trends affecting nursingTechnology and telemedicineThe use of technology in patient care has increased in the recent past. The incorporation of telemedicine care in Texas has revolutionized care by bringing the patient and the healthcare provider closer. The current platform requires that those practicing telemedicine demonstrate the recommended quality of care. The welfare of the patient is safeguarded through the use of the same evaluation system for the different clinicians.The use of technology in patient treatment and electronic healthcare records has made great impacts on patient outcomes. It is easier to attain evidence-based care through a comprehensive record keeping of the treatment process. Easier access to medical care through telecommunication channels has also increased patient-professional interactions. The provision of insurance policies for telemedicine services makes it more accessible to the general population. Patient factors that used to hinder professional advice in the past have now been avoided with quicker access to care regardless of the patient’s location. Response to emergency care has also been enhanced.The opportunities offered by technological advancements are immense. The main aim of using technology in the provision of healthcare is to increase coverage by improving access to care. Minimizing the cost of care has also been achieved through the use of telemedicine. The patient and the clinician can interact at any time without regard to physical location barriers (Kruse, 2017).Emerging trends that may have effects on the organizationThe increased shift from a fee for service form of care has led to more reforms in the settling of medical bills and the provision of insurance services. Reshaping patient pathways has been achieved through the shift from the payment of insurance services to a payment for the healthcare services directly. The rise of private insurers and risk management providers has led to a shift that concentrates more of the payment for healthcare services rather than paying for insurance against accidents which can be avoided.Due to the shift in insurance covers, the insurance providers have had to shift their services to more patient-friendly provisions. The improved insurance deals include lower costs for coverage and other provisions aimed at driving engagement.The incorporation of remote monitoring systems has reduced the need to incur insurance costs against fatal condition like heart failure. It is now possible to monitor the condition using technological remote devices. The expansion of the hospital environment beyond the confinement of the physical location of the facility is improving patient outcome scores and making health care more available to the population.Understanding the technological interventions available today and keeping at per with the trends will be a determinant of success in patient care. the use of digital remote monitoring systems will increase professional coverage and reduce the chances of developing medical emergencies through a comprehensive monitoring system. Efficient monitoring will, in turn, improve patient outcomes and reduce the cost of insurance. Both the healthcare organization and the patient are impacted positively by these changes with the only requirement being an advancement in technological skills (Jardim, 2013).The contribution of technology to reforming health careThe contribution of technological advancement in health care will have the most positive effect on patient care and the healthcare organization in general. All the advancements in technology serve the sole purpose of bringing the patient and the clinician together and working towards the same objective. The use of telemedicine has reduced the location barriers between the clinician and the patient. Incorporation of the patient record system in an electronic platform has increased the provision of evidence-based care through interdisciplinary collaboration through the organization’s network channels. The emerging of remote monitoring gadgets has aided in the provision of care to patients with chronic conditions like heart disease. Insurance covers on such conditions are reduced with effective monitoring.The primary negative impact on the advancement of technology-based care is the need for basic understanding of the technology being used. Learning a new technology can be easy when the target population is ready to incorporate it into the current system. It can also be problematic to caregivers who have been in the field for some time. The presence of a given way of doing things interferes with the adoption process of the new system.Trends in technological advancements will increase safety in patient care through the provision of reliable electronic data storage and the increased patient-professional interaction through telemedicine. Risk management and quality improvement in the organization will also be improved by the technological trends (Hoover, 2017).ReferencesCalsyn, M. a. (2014). Controlling costs by expanding the Medicare acute care episode demonstration. JAMA internal medicine, 172(9), 1438-1439.Hoover, R. (2017). Benefits of using an electronic health record. Nursing2017 Critical Care, 12(1), 9-10.Jardim, S. V. (2013). The electronic health record and its contribution to healthcare information systems interoperability. Procedia Technology, 9, 940-948.Kruse, C. S. (2017). Telehealth and patient satisfaction: a systematic review and narrative analysis. BMJ Open, 7(8).Shih, T. L. (2015). Will bundled payments change health care?: Examining the evidence thus far in cardiovascular care. Circulation, 131(24), 2151-2158.

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