Consumer-directed health plans
As a health care administrator, you will likely spend a great deal of your time focused on operations. You may find yourself working in a hospital, clinic, long-term care facility, hospice, urgent care center, home health agency, or a number of other types of organizations. Regardless of the type of organization, many of the operational responsibilities are the same.Health care financing has become quite complex. Because most health care organizations are reimbursed primarily from a third party (insurance company), health care administrators must manage the communication between the patient, the insurance company, and the organization. Consumer-directed health plans (CDHPs) have increased in popularity as a way to reduce insurance premiums; however, the patient has a larger financial responsibility for services compared to managed care plans. This concept is known as cost sharing (Niles, 2021). It is very important to understand the payer mix of your organization, so you understand where and how revenue is coming in.Information technology is another huge area of focus right now for health care administrators. The health care industry has lagged behind other industries in the area of information technology. The U.S. health care system has seen a large increase in the number of electronic medical records implemented across health care organizations (Niles, 2021). In addition, other technologies such as telehealth, electronic data warehouses (EDWs), and computerized physician order entry (CPOE) are quickly expanding and improving the delivery of health care.
Reference
Niles, N. J. (2021). Basics of the U.S. health care system (4th ed.). Jones & Bartlett Learning.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:
Competency 2: Explain health care management approaches in diverse health care settings.
Describe where the physician practice and the hospital fall on the continuum of patient care.
Analyze how providers at each location try to return their patients to their highest level of functioning.
Analyze the differences in the scope of responsibility and authority between the physician practice and the hospital administrator positions.
Describe how the management approach changes between physician practice and hospital settings.
Competency 4: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others.
Produce writing that conveys understanding of the topic, its context, and its relevance.
Use academic writing conventions such as APA formatting and citation style, or others as required.
Produce writing that includes minimal grammar, usage, and mechanical errors, including spelling.
Instructions
For this assessment, imagine you have decided to leave your position at the primary care office from your previous assessment. You have accepted an administrator position at an academic medical center that is noted for its diversity in staffing. Using the resources provided, along with a minimum of two peer-reviewed articles based on your own research, complete a 3–5 page paper discussing the following:
Describe where the physician practice and the hospital fall on the continuum of patient care. How do providers at each location try to return their patients to their highest level of functioning?
Explain the scope of responsibility and authority that you had at the physician practice, compared to your new role as a hospital administrator.
Describe how your management approach has changed across the two settings.
Organize your paper using the following headings (please use these headings):
Title Page.
Introduction.
Preview the main themes of your paper.
Continuum of Care.
Describe where the physician practice and the hospital fall on the continuum of patient care. How do providers at each location try to return their patients to their highest level of functioning?
Scope of Responsibility and Authority.
Analyze the scope of responsibility and authority that you had at the physician practice, compared to your new role as a hospital administrator.
The Management Approach.
Describe how your management approach has changed across the two settings.
Conclusion.
Summarize the main themes of your paper.
References.
Paper Requirements
Your paper will be a minimum of 3–5 double-spaced pages in length, not including title and reference pages.
Font: Times New Roman 12-point.
Cite at least two references in addition to the resources offered in this assessment.
Format your paper according to APA style.
Note: To fully understand how this assessment will be graded be sure to carefully read the Health Care Management in Diverse Settings Scoring Guide.
SCORING GUIDE
Use the scoring guide to understand how your assessment will be evaluated.VIEW SCORING GUIDE