Health Care Delivery Systems-Payment Mechanisms and Reform Initiatives under PPACA
Hide Description
Module 4 – SLP
PAYING FOR HOSPITAL AND PHYSICIAN SERVICES
Part I – Paying for Hospital Services
Discuss (in about 2-3 pages) the advantage and disadvantage of the following hospital payment systems on cost containment and provider behavior:
Part II – Paying for Physician Services
Using the background materials and the information you find from the literature and on the Internet, respond (in about 2-3 pages) to the following questions:
SLP Assignment Expectations
Length: Write a 2- to 3-page paper, typed and double spaced, with 12 pt. Times New Roman font and 1-inch page margins. Use headers throughout the paper. This will aid you in not overlooking vital elements of the assignment and make the document easier for the reader to follow.
Module 4 – Case
PAYING FOR HOSPITAL AND PHYSICIAN SERVICES
Case Assignment
Part I – Paying for Hospital Services – Overview
Mr. Scott is a 69-year-old hospitalized for a Permanent Cardiac Pacemaker procedure. Hillcrest Hospital is a large urban hospital in Cleveland that incurred $150,000 in Medicare-approved charges for treating Mr. Scott. Use the information provided in this module as well as the Hospital Payments Example, found in the Course Table of Contents under the Presentation section, to answer the Case 4 assignment questions. Include all formulas and calculations in your paper.
DRG | Description | Case Weight |
115 | Permanent Cardiac Pacemaker | 3.5513 |
302 | Kidney Transplant | 4.1370 |
441 | Hand Procedure/Surgery | 0.8785 |
Part I – Assignment
Answer (in about 3 pages) the following questions for Kidney Transplant only:
Part II – Paying for Physician Services – Overview
Mr. Roberts is a 66-year-old Medicare beneficiary. He sought treatments from Dr. Robinson. Assume the following values for the services provided by Dr. Robinson:
Categories | RVU | Geographic Cost Index | Product |
Work | 27.45 | 1.092 | 29.98 |
Practice Expense | 43.05 | 1.743 | 75.04 |
Malpractice | 10.32 | 0.543 | 5.60 |
Conversion Factor: 64.43 |
Part II – Assignment
Please answer in about 3 pages the following questions:
Assignment Expectations
Length: The paper should be typed and double spaced, using 12 pt. Times New Roman font and 1-inch page margins. Use headers throughout the paper. This will aid you in not overlooking vital elements of the assignment and make the document easier for the reader to follow.