Value-Based Purchasing Models: Contribution to Management and Decision-Making - Essay Sample

Introduction

In this discussion, we will cover the elements associated with the value-based purchasing models, and the contributions of these models conveyed in through management practices and decisions. Again the paper will consider shared risk models and their implications in the management and decisions and finally useful development of organizational culture by use of strategies.

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Components of Value-Based Purchasing Models:

Value-based purchasing models implementations will help the healthcare to promote the intended incentives for the physicians in correspondence to the objectives stipulated. These models involve four components that revolve around the following: the use of modern models for the organization to improve the quality of the services provided, collaborative governance, provision education, and vital information, and efforts to cater to the efficiency required.

The healthcare must implement and utilize new models that appropriately align the organization's objectives with the quality service through viable incentives. For instance, there must be agitation for physicians like surgeons to meet high standards that best match with the quality measures. Workable projects should be under implementation, and their results should be reliable since, in the medical field, everything must concise to avoid loss of life.

The hospital needs to embrace collaborative governance whereby the surgeons, anesthesia, nursing personnel, and administration executives should have representatives in the executive committee for the surgery services multidiscipline through the use of OR. The hospital has to make efficient educative programs and performance evaluation that is evidence-based that than concentrating on the outcomes by the entire hospital personnel (Samson et al., 2018). It is possible to do this if professional OR managers track and deliver data to the physicians and the staff for better coordination. The last element is putting efforts to push for efficiency in service delivery (Millwee, Goldfield, & Turnipseed, 2018). There is a need for the OR leaders to motivate the organization to make case time, labor, and non-labor expenses that could lead to inefficiency. For instance, the hospital oughts to measure case time and expose its health physicians to case lengths excessively to advance its efficiency regardless of the patient's number to make more income.

Shared Risk Models:

This health care organization needs to emulate the models that aim to create incentives for the service provider for the improvement of the volume and the costs of the services about the quality of care service delivery. The models that do not meet the requirements compelling in the efforts made for the quality service delivery must be replaceable with other modern models. It is recommendable for the organization to implement the appropriate models to advance and rectify the manage the collaboration of the operations for service delivery. They include accountable care organizations (ACOs), coordination fee, payment for the best performance (P4P), accumulated payments, upward-shared and downward-shared saving schemes, semi- or whole-capitation, and worldwide payments.

In accountable care organizations, there is coordination in offering care to the patients, the value of the payment for the service delivered is reasonable, and the risks incurred by the healthcare tent to shift towards the providers to staple the model in the care delivery (Homeret al., 2016). It should encompass groups of organizations and physicians to bring collaborative efforts and avoid losses directly affecting only one healthcare that can bring its enclosure.

In capitation payments, the organization oughts to have managers to enable it within the entire care delivery departments involved in the control of the budget. The poor performance management, the unutilized funds should cater for the payment of the deficit costs (Andoh-Adjei et al., 2018). Funds from outside parties like insurance finance surgery and healthcare institutions per case where service providers get capitated pay will help this health care service regarding quality delivery. It will further make the organization standardize payment for the physicians in terms of fee-for-service. The method will motivate service providers in critical and life-intensive care medical practices since it ensures that they get more in comparison to the office co-pay.

Shared savings in cases of lower spending than funds allocated commonly regarded as the entire cost of the caring benchmark, the organization should detect these funds for accountability when using upward-shared and downward-shared saving schemes. This Medicaid benchmark will convey averaged spending for a wide variety of health services offered in the healthcare service delivery (Kruk et al., 2018). The projection of this cost estimation will compare to the exact spending reflected by ACO's to determine either saving or loss generations incurred within the performance year.

Strategies to Develop a Productive Organizational Culture:

The management of this organization should stipulate the intended vision and values that assist managers in understanding the values the organization owe them for achieving the set objectives. Knowledgeable of the core values for the organization should be a trend that no executive should evade at whatever cost since they comprise of the approaches to customer success (Esfahani, Mosadeghrad, & Akbarisari, 2018). The articulation of these significant values should be in more straightforward concepts that are applicable and in understandable statements.

Transparent monitoring for the organization will direct approaches to reward the physicians that embody these fundamental values, and this will create a culture of not only satisfying the best but also methods for exposing others to learn from the best (Argote, & Miron-Spektor, 2018). This cultural practice in the organization will improve service delivery. Furthermore, clear and effective communication is another strategy that this organization should use to trigger optimality levels in the performance and implementation of other initiatives for the workers and the working environment.

Similarly, the promotion of transparency by the organization will create management trust and future sight for the company in building a positive culture in the workplace and productive healthcare providers' engagement. Finally, the recruitment of the right professionals with matching care service delivery skills will encourage appropriate partaking of the service provision responsibilities by the physicians and advance the productivity in terms of quality.

References

Esfahani, P., Mosadeghrad, A. M., & Akbarisari, A. (2018). “The success of strategic planning in health care organizations of Iran.” International journal of health care quality assurance.

Argote, L., & Miron-Spektor, E. (2011). “Organizational learning: From experience to knowledge.” Organization science, 22(5), 1123-1137.

Andoh-Adjei, F. X., Boudewijns, B., Nsiah-Boateng, E., Asante, F. A., van der Velden, K., & Spaan, E. (2018). “Effects of capitation payment on utilization and claims expenditure under National Health Insurance Scheme: a cross-sectional study of three regions in Ghana.” Health economics review, 8(1), 17.

Homer, J., Milstein, B., Hirsch, G. B., & Fisher, E. S. (2016). “Combined regional investments could substantially enhance health system performance and be financially affordable.” Health Affairs, 35(8), 1435-1443.

Kruk, M. E., Gage, A. D., Arsenault, C., Jordan, K., Leslie, H. H., Roder-DeWan, S., ... & English, M. (2018). “High-quality health systems in the Sustainable Development Goals era: time for a revolution.” The Lancet Global Health, 6(11), e1196-e1252.

Samson, L. W., Chen, L. M., Epstein, A. M., & Maddox, K. E. J. (2018). “Dually enrolled beneficiaries have higher episode costs on the Medicare spending per beneficiary measure.” Health Affairs, 37(1), 86-94.

Millwee, B., Goldfield, N., & Turnipseed, J. (2018). “Achieving improved outcomes through value-based purchasing in one state.” American Journal of Medical Quality, 33(2), 162-171.