Deliverable 5 – Revenue Cycle Management and Reimbursement Models
Scenario
After an evaluation of its current financial status and an assessment of future industry trends, the governing board for Metropolitan Memorial has approved its CEO’s request to expand operations into the rural areas of the state. Many of the rural residents rely upon Medicare and Medicaid for the financing of their healthcare needs. The hospital will offer satellite services including primary care, urgent care, telehealth, and emergent care services. The hospital is embracing the concept of value-based care given the economic make-up of the population within the rural community. Value-based care focuses on advancing the triple aim strategy of providing better care for individuals, improving population health management initiatives, and reducing overall health costs.
Instructions
The CEO has asked you to create a PowerPoint presentation (using speaker notes for each slide – do not overpower slide, use speaker notes for details and information) outlining the revenue cycle management process.
Your presentation should include a discussion on value-based care models as introduced by the Centers for Medicare and Medicaid Services (CMS), such as ACOs and the Medicare Shared Savings Program. (at least 2 or more examples)
In addition, based on the research you’ve done, you will need to include a recommendation for a possible strategy to strengthen the organization’s financial operations in preparation for the transition from FFS (fee-for-service) to VBC (value-based care). (at least 2 or more examples)
HSA5400 – Deliverable #5
What am I creating? PPT Presentation
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What needs to be included? Speaker notes OR Voiceover OR both – (Take NOTE: using speaker notes for each slide)
What content are we adding?
1. Outlining the RCM (Revenue Cycle Management) process
a. Include: Value-Based Care Models Definition per CMS
i. Include in the VBC discussion: ACO’s and Medicare Shared Savings Program
2. Conclude with a Recommendation that offers a STRATEGY to strengthen financial operations as we switch from FFS (fee-for-service) to VBC
Criteria #1: Clear and thorough discussion of value-based care models as introduced by the Centers for Medicare and Medicaid Services (CMS). Includes multiple examples or supporting details per topic.
Criteria #2: Comprehensive recommendation for a possible strategy to strengthen the organization’s financial operations in preparation for the transition to value-based care. Includes multiple examples or supporting details .
Criteria #3: Presentation included comprehensive speaker notes ((Take NOTE: using speaker notes for each slide) or narration.
Additional Resources:
RCM:
AAPC – What Is Revenue Cycle Management (RCM)?
TechTarget – revenue cycle management (RCM)
VBC Models:
What are the value-based programs?
ACO’s
Accountable Care and Accountable Care Organizations (CMS)
Medicare Shared Savings Program
Shared Savings Program (About the program) CMS
Strategy for implementing VBC
Five Strategies for Success When Implementing Value-Based Care
Preparing the Healthcare Revenue Cycle for Value-Based Care
Defining and Implementing Value-Based Health Care: A Strategic Framework