Question

Physicians have been affected by changes in managed care.

Explain how physicians can adapt to these changes and still practice medicine with the required quality of care.

Explain how quality of care can be achieved in a healthcare environment that is heavily influenced by managed care organizations.

Answer 1

Implementation of the pay for performance is very widely implemented into the Healthcare organisations. This type of terminology definitely provides mixed results as pay for performance directly increase the level of performance of the employer in expectation to get better wages. But this type of practice also reduces the level of clarity in the work as employees are consistently finding to bypass the performance measurement module which directly reduces the overall fairness of the data captured inside an organisation. Buy successfully implementing pay for performance in the organisation, level of implementation of the different Strategies for paying the employees could be improved.
For measuring the performance, employees overall present in the organisation as well as the effectiveness of the delivered service to the customer by taking the feedback from the patients about the customer care service and having an in-house observation unit would be very beneficial. This would definitely increase the level of monitoring of the specific individual inside the organisation.
Definitely physician can negatively impact the continuous quality improvement effects in an organisation. If a physician is not practical enough to implement changes and shows redundancy in adapting changes as well as provision of the services to the patients, overall impact of the changes could be very badly affected. Definitely reduces the level of efficiency for continuous quality improvement. Provision of the Quality Services but not putting in proper efforts is the biggest problems with the physicians in the Healthcare facilities.
In this condition changing the structure of payment from annual salary based structure to pay for performance based structure would be adequate as it would boost the overall level of motivation for the employees in the respective environment as employees would directly look into the factor that improvement in efficiency or performance return them with better incentive that would create a boost for the service provision of the organisation as well as providing advocate level of service support to its operation structure.

Reimbursements are one of the most important part of any doctor working inside the Healthcare facilities. Most of the physicians face extreme problems in getting the reimbursement in the Healthcare facilities some of them are as follows and the provision of reimbursement totally make sense on the basis of these factors.
Some of the top reimbursement challenges that physician face are as follows.
Management of chronic care
Technologically patient-centered care
Management of chronic care
As most of the doctors are not fully prepared to care for the patient with extremely chronic diseases. Most of the people inside the United States of America suffer from the chronic diseases and this number is used as it reaches the 117 million. 86 percentage of total Health Care costs are used for the electronic health record as well as the disease control and prevention. By implementing new programs into the organisation is just a small initiative to reduce the overall Association with the chronic diseases.
Medicare chronic Care Management Service has began reimbursing the positions by $40.00 perman for every chronic Care Management Services related patient. This is a beneficial thing for the doctors but providing this is Pacific money to the doctors is very tough according to the structure.
By having a reimbursement to meet all the requirements of the specific solutions Medicare costs in the management directly reduces the overall given time and sometimes it's not even provided by a specific mean. Detail the patient specific health problems as well as treatment goals and prognosis. It also state the need for the social services for the patient. Capturing all of this information inside the electronic health record system can be very challenging for the present position as they have to maintain a balance between their working structure as well as feeding the data into the system.
These specific numbers are about $40 per month per member for a physician which is very less.
This specific problem is one of the biggest reimbursement challenges that should be being faced by the physicians in upcoming 3 years.
Technologically patient-centered care
As the world is turning to what the digital age the healthcare systems are also turning digital which is creating problems for the physician. Different technologically advanced gadgets such as a variable things are one of the most controversial things in the industry.
Implementation of this specific strategy into the Healthcare systems is mostly unrecognised by some old suggestions which are directly non relatable to the technological improvements. For them wearable technology is Aaye technology of aliens and I cannot manage to work with it.
This is specific Technology has its own benefit and reduces the overall communication time between the patient and the doctor. By reducing the overall communication time between the patient and doctor the Healthcare provision in the critical disease like heart diseases can be prevented.
Implementation of these specific technological tools are a real challenge in reimbursement for the physician in next 3 years as the implementation of these specific technologies are really tough for implementing into the past area of Healthcare network. This is weather get strategy is still struggling to make a meaningful changed in the Healthcare organisation and should be recognised by the payer as well

References - https://catalyst.nejm.org/pay-for-performance-in-healthcare/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2234517/
P.S.- Please leave a comment if any explanation is needed.