Business > CASE STUDY > Financial Resource Management in Healthcare Task 1.docx Financial Resource Management i (All)
Financial Resource Management in Healthcare Task 1.docx Financial Resource Management in Healthcare Task 1 Western Governors University Seamus Company currently has fee for service model for thei... r healthcare insurance. Fee for service model means that the providers and/or organizations are paid based on what service they provide the patient. For example, hospitals are paid for admissions, lab are based on the labs they perform and radiology on the MRIs, CT scans and x rays they complete. This is the same for the physicians. They are also paid based on the office visit as well as any additional testing they do. This type of payment can encourage physician and organizations to perform additional testing and services that may not be necessary in order to obtain a higher reimbursement payment from the insurance company. As the CFO I have been analyzing our health plans as well as others. I have come up with the following options that I believe will allow our company to be financially sustainable for the following fiscal year. These changes will help our company save money without affecting the welfare of our employees. A1. Three Fiscally Sustainable Strategies/ to an MCO Model To save money without affecting the welfare of our employees I suggest we take a look at these 3 options for our health plans in the coming fiscal year. For the 1st option, I suggest moving from a Fee-for service plan to a Preferred Provider Organization (PPO). PPOs are providers that are a part of a preferred network (covered by the plan). This plan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .. .. . . . . . . . . . . . . . . . . . .. . . . . [Show More]
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