Question

1. Why is it necessary to understand how quality care can impact reimbursement for services provided?

Answer 1

In todays health care system, public and private health payers are trying on new ways to reduce rising expense on health care. Both payers and providers seek to move from fee fro services to value based care reimbursement. Health care reimbursement is changing to quality care where physicians and hospital are paid based on quality and not on volume of services provided.

Value based care reimbursement is gaining more importance and popularity. This is making relationship between payers and providers much more collaborative. More focus on working together to increase quality and affordability , so that patients have better outcomes and experience. Provider goals include accountability to Patients, creating advanced care team , nursing care managers and pharmacists, intimation if automated process to address prevention and wellness.

Alternative payment models generally make doctors and hospitals attentive to total cost of treating a patient at a high level of quality giving clinicians an opportunity to quality patient centered care.

Value based care shifts the health care to a new model that emphasis importance on keeping people healthy and rewards on physician s for coordinating care, providing appropriate care for each patient and for actual health outcomes. This type of reimbursement increases quality and decrease cost by using financial incentives to promote cost efficient health care services and consumer choice. Health care plans can be designed to reduce barriers to maintaining and improving health.This form hold the health care providers accountable for both cost and quality of care they provide. it attempts to reduce inappropriate care and to identify and reward best performing providers.