What steps must be taken in order to receive reimbursement for services?

Overview

Prepare a lecture for an introductory health care finance class on types of revenue sources for health care organizations. For each revenue source, explain the purpose of the program, how the organization is reimbursed, and the benefits of the program.

Note: The assessments in this course build upon each other, so you are strongly encouraged to complete them in sequence.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

· Competency 1: Develop financial strategies to address dynamic environmental forces. (L24.2, L24.5, L17.2)

· Explain the benefits of reimbursement programs.

· Competency 2: Analyze the cost and revenue implications for organizational changes due to environmental forces. (L18.2, L12.1)

· Analyze the reimbursement process health care organizations must undertake.

· Competency 4: Communicate in a manner that is scholarly, professional, and consistent with expectations for professionals in health care administration. (L6.1, L6.2, L6.3, L6.4)

· Explain the purpose of health care reimbursement programs.

· Write content clearly and logically with correct use of grammar, punctuation, and mechanics.

· Format citations and references using APA style.

Context

Sustainable health care organizations are charged with balancing clinical and fiscal facets of the operation. It has become increasingly important for health care leaders at all levels within an organization to become comfortable with financial statements and basic accounting principles. As an early careerist, you may be involved in conversations to evaluate existing and new health care service lines. You may be asked to participate in various financial activities, such as team budgeting activities, development of a departmental budget, or contributing to strategic planning or finance department meetings. As a mid or advanced careerist, you may be evaluating higher-level organization financing options, determining cash flow needs, or perhaps presenting financial information to the CEO and board.

Regardless of your position within the organization, a basic understanding of health care finance is a critical success factor for effective and responsible health care leadership.

Questions to Consider

To deepen your understanding, you are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community.

· What types of accounting are you familiar with? How have you used it or seen it used?

· How can you use knowledge of revenue sources to help in financial forecasting?

Resources

Suggested Resources

The following optional resources are provided to support you in completing the assessment or to provide a helpful context. For additional resources, refer to the Research Resources and Supplemental Resources in the left navigation menu of your courseroom.

· Health Care Finance Flashcards | Transcript. (attached)

Internet Resources

Access the following resources by clicking the links provided. Please note that URLs change frequently. Permissions for the following links have either been granted or deemed appropriate for educational use at the time of course publication.

· Medicare.gov. (n.d.). Retrieved from https://www.medicare.gov/

· Medicaid.gov. (n.d.). Retrieved from https://www.medicaid.gov/

· U.S. National Library of Medicine: Medline Plus. (n.d.). Managed care. Retrieved from http://www.nlm.nih.gov/medlineplus/managedcare.html

· Healthcare Financial Management Association. (2016). Retrieved from http://www.hfma.org/

Bookstore Resources

· Harrison, C., & Harrison, W. P. (2013). Introduction to health care finance and accounting. Clifton Park, NY: Cengage Learning/Delmar.

· Chapters 1, 2, and 3.

· Assessment Instructions

Preparation

Look in the library and on the Internet to find resources on Medicare, Medicaid, and managed care. Specifically, you need information on what each program is, how it works, and how organizations receive reimbursements from each. You will need these resources to complete this assessment.

For the purposes of this assessment, suppose you work for a large health care organization that partners with the local college on a number of initiatives. As part of that partnership, you have been asked to be a guest presenter for an introductory health care finance class. You need to explain sources of health care revenue and how the reimbursement process works. You need to prepare a 45-minute lecture on that topic.

There is no prescribed format for this assessment, but you must reference at least three resources and follow APA guidelines. If you wish, you may use the APA-formatted template located in the suggested resources section, but you are not required to do so. Just be sure that your assessment is organized logically and your information is presented clearly.

Requirements

Write a 45-minute (you will not be evaluated on whether your lecture plan is actually 45 minutes in length) lecture plan for an introductory health care finance class. The three types of revenue sources you will cover are:

· Medicaid.

· Medicare.