AH531 Financial Management Week 1 Assignment Statement of Operations and Financial Statements1
Statement of Operations and Financial Operations
Crystal A. Dilliard
Grantham University
AH531 Healthcare Financial Management
Professor Keith LaPrade
April 7, 2015
Statement of Operations and Financial Operations
1. List several efforts that have been enacted by payors to control costs. Several efforts have been enacted by payors to control costs. Many agree healthcare reform and controlling health care costs began as early as the 1960s, when federal funded Medicare, and federal and state funded Medicaid programs, reimbursed institutions for healthcare. Medicare eligible Americans 65 years of age and older, and Medicaid eligible Americans in the low income brackets receive health care coverage under these plans, requiring health care organizations and providers to comply with regulatory guidelines and set standards, necessary for reimbursement. In the 1980s, fee of service became popular as a method used by payors to control costs. But, it wasn’t until 2005, when the Deficit Reduction Act authorized the Centers for Medicare and Medicaid Services (CMS), offered up to further control Medicare costs by going from quantity of services provided for reimbursement, to a value-based purchasing (VBP) method, measuring quality of care standards, for reimbursement. Then in 2010, when the Affordable Care Act (ACA), this effort increased awareness regarding the need for access to care, affordability of care, and quality of services, and a plan of implementation was developed by the ACA initiators to work toward effectively financing the nation’s health care system, designed to lower costs, while providing quality of care (Zelman, McCue, Glick, & Thomas, p. 1-2, 2014). As a Clinical Case Manager, this author understands the value of controlling costs. These efforts enacted by payors require institutions to develop more efficient business models and delivery of care systems, and managed care efforts help to control costs. Hospitals are focusing on
Crystal A. Dilliard
Grantham University
AH531 Healthcare Financial Management
Professor Keith LaPrade
April 7, 2015
Statement of Operations and Financial Operations
1. List several efforts that have been enacted by payors to control costs. Several efforts have been enacted by payors to control costs. Many agree healthcare reform and controlling health care costs began as early as the 1960s, when federal funded Medicare, and federal and state funded Medicaid programs, reimbursed institutions for healthcare. Medicare eligible Americans 65 years of age and older, and Medicaid eligible Americans in the low income brackets receive health care coverage under these plans, requiring health care organizations and providers to comply with regulatory guidelines and set standards, necessary for reimbursement. In the 1980s, fee of service became popular as a method used by payors to control costs. But, it wasn’t until 2005, when the Deficit Reduction Act authorized the Centers for Medicare and Medicaid Services (CMS), offered up to further control Medicare costs by going from quantity of services provided for reimbursement, to a value-based purchasing (VBP) method, measuring quality of care standards, for reimbursement. Then in 2010, when the Affordable Care Act (ACA), this effort increased awareness regarding the need for access to care, affordability of care, and quality of services, and a plan of implementation was developed by the ACA initiators to work toward effectively financing the nation’s health care system, designed to lower costs, while providing quality of care (Zelman, McCue, Glick, & Thomas, p. 1-2, 2014). As a Clinical Case Manager, this author understands the value of controlling costs. These efforts enacted by payors require institutions to develop more efficient business models and delivery of care systems, and managed care efforts help to control costs. Hospitals are focusing on
References: Bierbauer, C. (1999, July 13). Law limits HMO lawsuits. Retrieved April 5, 2015, from http://www.cnn.com/US/9907/13/patients.rights/index.html Zelman, W. N., McCue, M. J., Glick, N. D., & Thomas, M. S. (2014). Financial management of health care organizations: An introduction to fundamental tools, concepts, and applications. San Francisco, CA: Jossey-Bass.