RUBRIC:
Peer interaction: 20 pts
20 pts
Exceptional
One post written in response to fellow learners’ post and is between 100-150 words. Response is substantive insightful and contain at least one reference.
Grammar, Syntax & APA formatting: Postings contain no grammatical or typographical errors. Citations in the post adhere to APA format as well as references noted at the end of the post (one to two errors). (Example: excluding double-spacing and indentation of the second and subsequent lines within the reference). No more than 25% of your paper should be direct quotes.
Student’s Post:
Value-based reimbursement in the U.S. incentivizes the quality of care rather than quantity; outcome-based reimbursement is the goal. There has been significant growth in the number of states implementing value-based care in the recent past. The value-based payment was designed to shift costs based on the number of services to ones that reimburse cost-effective, high-quality care (Erickson et al., 2020). This reimbursement model is being delivered across the United States to reduce costs, improve quality, and change how providers are compensated for their services.
Improvement of U.S. healthcare necessitates the pursuit of the Triple Aim initiative to improve the populations’ health, improve the care experience, and reduce healthcare costs. The Triple Aim components have interdependent goals. For instance, the pursuit of improving care can raise costs. The concepts of value vs. volume compare the value-based and volume-based payment models. The idea of value reimburses providers based on the patients’ outcome or quality of care, and it lowers the costs and is more aligned to the Triple Aim initiative.
Population health management is highly dependent on data. Nash et al. (2021) argue that population health data analytics is crucial to identifying populations needing care or high-risk areas. Data is also essential to assess the care delivered to populations and help providers provide the appropriate care to the right individuals. Risk stratification allows providers to identify the proper level of care or services for specific populations. Segmenting patient populations via risk stratification is essential in forming an appropriate population health strategy that understands patients’ needs and issues. A DNP-prepared nurse can use this information to direct care among populations and improve overall health outcomes. In addition, the data can enable DNPs to lead a multidisciplinary team to work collaboratively with physicians, physician assistants, coordinators, care managers, specialists, and other health professionals to drive care management.
References
Erickson, S. M., Outland, B., Joy, S., Rockwern, B., Serchen, J., Mire, R. D., & Goldman, J. M. (2020). Envisioning a better U.S. health care system for all: health care delivery and payment system reforms. Annals of internal medicine, 172(2_Supplement), S33-S49.
Nash, D. B., Fabius, R. J., Skoufalos, A., & Clarke, J. L. (2021). Population health: Creating a culture of wellness. (3rd ed.). Jones & Bartlett Publishers.
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