Question

Please define on your own words!

National Practioner Data Banlk National Provider Identifier Capitation Withholders P4p Global Capitation 50 ward

Answer 1

The National Practitioner Data Bank is a web-based repository of reports containing information on medical malpractice payments and certain adverse actions related to health care practitioners, providers, and suppliers.

On the basis of the above the Data Bank was created with the primary goals of improving health care quality, protecting the public and reducing health care fraud and abuse. The Data Bank incorporated the National Practitioner Data Bank and the Healthcare Integrity and Protection Data Bank.

The data that is collected and saved as data in the National Practitioner Data Bank are records of actions taken by authorized organizations regarding health care practitioners, entities, providers, and suppliers who do not meet professional standards. These are the records that are reportable actions include medical malpractice payments and health care-related adverse actions.

The National Healthcare Integrity and Protection Data Bank established by the Health Insurance Portability and Accountability Act. This system of reporting to the new data bank started and The National Healthcare Integrity and Protection Data Bank was created to combat fraud and abuse in health insurance and health care delivery.

A National Provider Identifier is a unique 10-digit identification number issued to health care providers by the Centres for Medicare and Medicaid Services. The National Provider Identifier is used on claims forms by all health care providers who meet the definition of covered entity. All Individuals and Organizations who meet the definition of health care provider as described are eligible to obtain a National Provider Identifier. If you are a HIPAA covered provider or if you are a health care provider or supplier who bills Medicare for your services, need a National Provider Identifier No.

In the above system, Capitation is a payment arrangement for health care service providers such as physicians, physician assistants or nurse practitioners. It pays a physician or group of physicians a set amount for each enrolled person assigned to them, per period of time, irrespective of whether or not that person seeks care.

Capitation payments are payments agreed upon in a capitated contract with respect to the above mentioned system by a health insurance company and a medical provider. They are fixed, and prearranged monthly payments are received by a physician, clinic or hospital per patient enrolled in a health plan. Here a capitated contract is a healthcare plan that allows payment of a flat fee for each patient it covers. Under a capitated contract, managed care organization pays a fixed amount of money for its members to the health care provider.

The term withholders might sound as if withholders are self - serving people who only strive for their own gains at their partner's expense.

Here the most common and destructive conflict patterns interact when one the partner continuously withholds and the other similarly concedes. Withholders keep their thoughts and feelings hidden during a conflict, while conceders too quickly reveal them. When these conflict styles interact, the withholders usually win. Holding their internal experiences close to the vest, they are able to expose the other partner’s internal experiences without reciprocating vulnerability. That gives them both the advantage in the argument and the power to resolve the conflict in their own favour.

The term P4P is referred to as People for Planet. As per the Ring Magazine it is referred as pound for pound. Pay for performance, in health care, human resources, advertising, etc. In the healthcare industry, pay for performance P4P, also known as value based purchasing, is a payment model that offers financial incentives to physicians, hospitals, medical groups, and other healthcare providers for meeting certain performance measures.

Now lastly, global capitation is a payment model specifically for integrated health care delivery. In this model, capitation payment for services delivered by different providers or at different levels of care is combined into a single prospective payment to an integrated care organization or a large physician group. The provider is then responsible for delivering all needed care for a defined population and for distributing payments to its constituent providers out of the capitation pool. The concept is that total payment does not vary based on the actual services provided to individuals in the population served.