The Challenges for Managing Providers within a Fee-for-Services versus a Risk-Based Contracting Plan MHA FPX 5028 Assessment 3

 

Furthermore, as per MacKay-Lyon et al. (2020), the study shows that if the healthcare providers who care for all patients share risks, the providers have a greater chance to cure deadly diseases such as stroke or cancer. In many states, the prevalence of financial risks differs such as 18% in Central and 24% in Northern California. The fact remains that risk-based payment models also make the practitioners accountable for provide a high quality care to stroke patients. This makes them more efficient; however, this model is also known as the risk-based payer model. All the providers receive their payment as they treat a patient and are also questioned for using the budget per patient. Therefore, in this method, there is low reward prospect for the practitioners for offering their holistic services in a value-based care system. Whereas, in risk-based model, healthcare insurance companies such as Medicare create partnership with hospitals and transfer monetary risks to providers. This includes capitalized payments in bundles. This provides better incentive to practitioners in the United States and Canada. Therefore, in the near future, the organization must switch from fee-for-services to risk-based contracting payment systems. 

References

MacKay-Lyons, M., Billinger, S. A., Eng, J. J., Dromerick, A., Giacomantonio, N., Hafer-Macko, C., Macko, R., Nguyen, E., Prior, P., Suskin, N., Tang, A., Thornton, M., & Unsworth, K. (2020). Aerobic exercise recommendations to optimize best practices in care after stroke: aerobics 2019 update. Physical Therapy, 100(1), 149–156. https://doi.org/10.1093/ptj/pzz153

Muehlschlegel S. (2018). Subarachnoid hemorrhage. Continuum (Minneapolis, Minn.), 24(6), 1623–1657. https://doi.org/10.1212/CON.0000000000000679

Oliveros, E., Patel, H., Kyung, S., Fugar, S., Goldberg, A., Madan, N., & Williams, K. A. (2020). Hypertension in older adults: assessment, management, and challenges. Clinical Cardiology, 43(2), 99–107. https://doi.org/10.1002/clc.23303

Powers, W. J., Rabinstein, A. A., Ackerson, T., Adeoye, O. M., Bambakidis, N. C., Becker, K., Biller, J., Brown, M., Demaerschalk, B. M., Hoh, B., Jauch, E. C., Kidwell, C. S., Leslie-Mazwi, T. M., Ovbiagele, B., Scott, P. A., Sheth, K. N., Southerland, A. M., Summers, D. V., & Tirschwell, D. L. (2019). Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the American heart association/American stroke association. Stroke, 50(12), e344–e418. https://doi.org/10.1161/STR.0000000000000211

MHA FPX 5028 Assessment 3 Attempt 1 Best Practices Report