Instructions: Post 2 replies of at least 250 words. Each reply must incorporate at least 1 scholarly citation in APA format. Each reply should include integration of Biblical Worldview with supporting scripture. Any sources cited must have been published within the last five years. Acceptable sources include the textbook, the Bible, peer- reviewed journal articles.
Classmate 1: Technology and Healthcare Reimbursement
Healthcare quality measures were created by government agencies and health insurance companies to measure aspects of care that they thought were important and didn’t consider the diverse communities. Pay for performance, value-based payment and accountable care organizations rely on the appropriate quality metrics for their reimbursement (Culhane-Pera, Pergament, Kasouaher, Pattock, Dhore, Kaigama, Alison, Scandrett, Mai, & Satin, 2021). Healthcare administrators must reduce cost and improve patient outcomes, so they are switching from a fee for service reimbursement model to a value-based payment model to remain competitive. Value-based hospital care was created to reduce medical errors, improve communication, secure patient information, and increase the quality of care for patients.
Reimbursement incentives can impact the use of technology in the healthcare world in a positive way because it encourages providers to get an Electronic Health Record system to get reimbursed for patient care. There are two programs that providers are eligible for which is Medicare and Medicaid. With the Medicare program all physicians are eligible to participate in the financial program no matter what percentage is being treated by each physician. But to receive an incentive from Medicaid a physician must have a 30% Medicaid patient population to be eligible. The downside to the financial incentive program is if the healthcare providers fail to implement the EHR system by 2015 their Medicare reimbursement decreases (Nelson & Staggers, 2018).
Health care systems are looking to design incentive programs that promote physician autonomy while reducing the potential for adverse ethical and legal consequences (Vilendrer, Asch, Anzai, & Maggio, 2020).
There’s a program that organizations are trying out that is called physician-directed reinvestment. This program is an agreement with the health care system to reinvest a portion of savings that physicians saved from their physician led cost reduction initiatives. With this incentive the health care system will give back to areas of the physicians liking such as education, a specific department, research projects, technology, or capital investments. This investment is to help current and future patient’s delivery of care.
Christian healthcare embraces the teachings of common good, human dignity and subsidiarity. The moral duty of a follower of Christ is to care for one’s neighbor and should always be congruous with our understanding and belief of our duty to display a merciful and compassionate love for our neighbor (Cuellar De la Cruz & Robinson, 2017). Using technology to save someone’s life is judged upon the Christian meaning of life but if you don’t have the technology people can die. “But ye are forgers of lies, ye are all physicians of no value” King James Bible, JOB 13:4, 2020). Access to quality healthcare is tied to the common good and physicians are worthless if they can’t provide Christ centered healthcare to the community.
Classmate 2: Value-based care initiatives aim to sway physician’s efforts to a more long-term, preventative, and general health perspective rather than to treat single patient issues. Potential benefits of value-based care are delivery of higher quality care, improved patient outcomes, and decreased cost of healthcare for many individuals (Nelson & Staggers, 2018). Shifts in insurance reimbursement models to a value centered approach would encourage physicians to treat the patient rather than the disease, injury, or diagnosis. This mindset would also encourage preventative care and potentially decrease the need for surgeries, development of comorbidities, and improved quality of life. One identified benefit of this changeover is to decrease incidences of physicians seeing high quantities of patients for reimbursement purposes and encourage them to improve quality care for select patients (Health It Playbook, 2019). The initiative and strive for delivery of quality patient care has been identified for years. Implementation of value-based payment reimbursement models is yet another tactic that can be used to accomplish this goal.
One definite concern that I can identify is the issue of patient compliance and follow-through with care. If physicians and healthcare systems are to be reimbursed based on patient outcomes, care compliance should be a major consideration for reimbursement. In many instances patients can be given all the tools necessary to succeed in preventative care efforts. It is ultimately the patient’s decision to make the proper lifestyle changes necessary to obtain a higher quality of life. It is the physician and healthcare system’s responsibility to provide patients with all the necessary tools, information, and follow-up care necessary to succeed, but there is an element to this that is left up to the patient and how they choose to use these tools. A physician can prescribe, educate, and encourage the patient to provide the best quality of care possible. However, the patient’s outcome is completely dependent on their ability to implement these changes. In order to help alleviate this dependance on the patient’s choices, physicians may benefit from encouraging patients to attend peer-support groups, therapy appointments, and educational courses.
When a facility is considering changing over to a value-based reimbursement approach, feasibility and potential outcomes need to be considered. Implementation of information technology may be beneficial in this process to determine specific needs and targets within the facility’s community (Francavilla, 2019). Feasibility studies need to be performed in order to determine if the facility is prepared to meet the standards outlined by value-based reimbursement. One major consideration when making this transition is the use of a variety of different specialties involved in patient care. In order for value-based care to be successful, facilities cannot specifically rely on physicians to provide all the necessary resources for positive patient outcomes. Use of a variety of professions such as care coordinators, nurses, therapists, and social workers will provide the best chances for patient outcomes (Francavilla, 2019).
Nurses play a special role in implementation of value-based reimbursement models. Some primary care locations may not have affiliations with all of the above professions. The nurse can serve an important role in patient education, determining specific patient needs or weaknesses at home, and forming patient bonds that will encourage honest and transparent communication regarding their needs and concerns. As Christian nurses, this style of care should be strived for whether our facility has implemented value-based reimbursement models or not. Delivering this style of care shows a special desire for seeing patients have improved quality of life through no gain of our own. Matther 5:16 (NIV)- “In the same way, let your light shine before others, that they may see your good deeds and glorify your Father in heaven.” Providing value-based care ideals allows Christian nurses the opportunity to display our love for Christ and our testimony with others.