Reference no: EM133185774
1.) A healthcare organization's annual report is a tool used to provide financial transparency to the community it serves. Locate an online copy of a healthcare organization's annual report to examine and share. Identify THREE unique features within the report and comment on them. Examine the overall visual appearance of the report and comment on whether you feel the average consumer could easily understand the report. Lastly, write ONE question you would like to ask the chief financial officer of the organization based on your review of the annual report.
Also include the link to your source report.
2.) Differentiate between a top-down and bottom-up approach to developing a budget.
3.) Compare the advantages and disadvantages of fixed and flexible budgeting.
4.) The concept of ACOs has been around since 2005. The ACA strengthened the commitment of CMS to expand ACO programs for Medicare. Currently, there are over 480 ACOs participating in CMS Medicare Shared Savings Program (MSSP). ACOs are responsible for the health outcomes for beneficiaries attributed to their organization. Therefore, ACOs will share savings (expenditures less than predicted) or return payments back to CMS based on their patient population.
Is it fair for CMS to hold providers accountable for the actions of their beneficiaries? For example, a physician counsels patients about weight loss and a healthy diet. Only a portion of their patients will change their eating and exercise habits. For those who do not, is it fair to hold the provider responsible for the patient's future healthcare expenditures? Should the patient be held accountable? How could CMS hold the patient accountable for their decision to ignore physician instruction? Answer these questions fully. This is your personal opinion so be as detailed and specific as you can be.
5.) Calvin saw his PCP, Dr. Washington because he had a fever and a sore throat. Dr. Washington ordered and performed a rapid strep test. Calvin's test was positive, and he was diagnosed with streptococcal pharyngitis (strep throat). Dr. Washington wrote Calvin a prescription for amoxicillin to treat pharyngitis. Dr. Washington submitted the following charges to Calvin's insurance company, Super Payer:
Clinic visit, level 2: $145
Rapid strep test: $50
Dr. Washington's practice has a contract with Super Payer and the reimbursement methodology is a fee schedule. The fee schedule rate for a level 2 clinic visit is $70 and the fee schedule rate for a rapid strep test is $10. What is the total reimbursement Dr. Washington will receive for Calvin's office visit? (Provide your answer as a dollar figure)
6.) Super Payer has a contract with Community Hospital to provide inpatient care for their beneficiaries. They have agreed to a per diem reimbursement methodology. ICU days are reimbursed at $5,000 per day and medical bed days are reimbursed at $3,500 per day. Community Hospital submitted a claim for a six-day LOS. Two of the six days were ICU days and four of the six days were medical bed days. What is the total reimbursement owed to Community Hospital for this admission? (Provide your answer as a dollar figure)