value based purchasing
Current trends in healthcare, the recent recession and sluggish economic environment, and the passage of the Affordable Care Act have forced the U.S. healthcare system to develop better ways to provide effective care for less cost. Healthcare providers and facilities must demonstrate to the government, payers, and the public that they provide care that is high quality, safe, and at a reasonable cost. Becoming a healthcare provider of choice while closely managing the costs of doing business and ensuring appropriate financial reimbursements is the new reality for organizations and providers in the healthcare arena.
This assessment challenges you to demonstrate understanding of today’s complex healthcare environment while using the business and financial skills learned to develop a strategic plan to move your organization from the world of fee-for-service (FFS) to value based purchasing (VBP). You will evaluate your organization’s position and strategy for the implementation of VBP requirements. You will need to identify the key stakeholders that would be involved (e.g., board members, senior leadership team, physicians, directors, managers, staff, patients, and families). You will also need to identify the critical departments of your organization (e.g., nursing, clinical support departments, case management, supply chain, education, finance, decision support, risk management, revenue cycle, medical staff office, physician services, physician practices, community and public relations, marketing). Consider the various roles and functions for each department and stakeholder group and determine which roles should be included in a strategic plan that you will develop.
Your strategic plan will include elements to educate, communicate, mobilize, and monitor the tactics you wish to implement. You will identify the clinical and customer service components of VBP in the next three years and develop a strategy to identify, educate, and inform all stakeholders of the organization’s vision to achieve excellence in patient care and the highest reimbursements possible for the next three years.
Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. Use the Turnitin Originality Report available in Taskstream as a guide for this measure of originality.
You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.
Note: Your submission may be in the format of a business plan document or a multimedia presentation. If a multimedia presentation is selected, speaker notes must be used to include the necessary level of detail and support. The executive summary in requirement C must be a separate document.
A. Evaluate your organization’s current status with implementation of VBP by doing the following:
1. Discuss to what degree your organization has embraced VBP.
B. Create a strategic plan to continue progressing VBP in your organization by doing the following:
1. Identify three departments that will have the most impact on VBP in your organization.
a. Explain why the roles and functions of these three departments are important for implementing VBP in your organization.
2. Discuss goals, for each of the three departments, that will help your organization further the implementation of VBP.
3. Describe how each of the goals chosen in part B2 will help attain quality outcomes in both patient care and reimbursements over the next three years.
4. Identify the key points for your strategic plan that are critical for the staff to understand and embrace.
a. Discuss how you would market the key points of your plan to staff members.
4. Reflect on how ethical clinical and ethical business practices will be incorporated into the strategic plan.
6. Explain how to coordinate informational and educational events for the three departments identified in part B1.
7. Develop a timeline to ensure that VBP is addressed over the next three years.
C. Develop an executive summary as a separate document for key stakeholders and critical department leaders that includes the following:
1. A description of the components of VBP that are most pertinent to the organization.
2. The preparation that the three departments chosen in part B1 will need for the implementation of VBP in the next three years.
3. A discussion of the education and training necessary to prepare the staff in the departments chosen in part B1 for implementation of VBP
D. When you use sources, include all in-text citations and references in APA format.
Note: For definitions of terms commonly used in the rubric, see the Rubric Terms web link included in the Evaluation Procedures section.
Note: When using sources to support ideas and elements in an assessment, the submission MUST include APA formatted in-text citations with a corresponding reference list for any direct quotes or paraphrasing. It is not necessary to list sources that were consulted if they have not been quoted or paraphrased in the text of the assessment.
Note: No more than a combined total of 30% of a submission can be directly quoted or closely paraphrased from outside sources, even if cited correctly.