HITT217 Health Insurance And Reimbursement

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HITT217 Health Insurance And Reimbursement

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HITT217 Health Insurance And Reimbursement

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Course Code: HITT217
University: Bucks County Community College

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Country: United States

Question:

You are a healthcare administrator and have been tasked with the job of making improvements to one of the four PACs (Postacute care). One consideration to keep in mind when reviewing the PACs is how high-quality patient care can be delivered at a cost appropriate for the condition of your patients.

Described post-acute care setting type home health agencies (HHAs).
How does the HHAs address the consideration of balancing high-quality care with affordability for the patient?

Answer:

1. Post-acute care settings in home health agencies (HHAs) must include rehabilitation, aged care and palliative care services. Depending on the intensity of care required by the patients, the treatment might include a stay facility in the HHA, an ongoing outpatient therapy and the residential care settings for the aged care. The entire set-up must be equipped with proper medications, medical instruments, trained healthcare professionals and other medical set-ups (American Hospital Association, 2018).
2. According to Landers et al. (2016), America is experiencing a dramatic shift in its demography. By the end of 2019, people who are 65-years old or more will gradually out-number the younger adults or children (5-year old). This increase in life-span will lead to an increase in multiple chronic diseases. Thus, the greatest health challenge is managing high-quality care along with affordability. Institute of Medicine (IOM) and National Research Council (NRC) are of the opinion that in order to maintain quality of care while maintaining the affordability, the HHAs must be Medicare-certified. According to the Medicare Payment Advisory Commission (MedPAC) medicare-certificate, insurance of the HHA will help to increase the insurance coverage of the service users of the post acute care. 30% of traditional (fee-for service [FFS]) Medicare payments will help to increase the quality of care and value added service will be provided with the helped of alternative payment models. Rest will depend on the Hospital Value-Based Purchasing Program (HVBP) and Hospital Re-admissions Reduction Program (HRRP) under HHAs. This insurance coverage will help to bring down the total payable cost of care while retaining the affordability (Landers et al., 2016).
References
American Hospital Association. (2018). Post-Acute Care. Access date: 22nd November, 2018. Retrieved from: https://www.aha.org/advocacy/long-term-care-and-rehabilitation
Landers, S., Madigan, E., Leff, B., Rosati, R. J., McCann, B. A., Hornbake, R., … & Lee, T. (2016). The future of home health care: a strategic framework for optimizing value. Home health care management & practice, 28(4), 262-278.

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