Reimbursement Model In Health Care
Our organization is a multi-specialty, multi-facility private medical practice consisting of six urgent care centers, three primary care offices and one pediatric office, providing services in six counties of Northeast Georgia. The practice is over 30 years old and is privately held as a limited liability company and currently employs approximately 110 in personnel.
The physician-owned practice exists in an evolving market, which traditionally did not require highly skilled positions apart from the medical providers but now necessitates extensive skills from all medical and support staff. As reimbursement migrates from fee-for-service to value-based models, practices are forced to hire and train employees in new, untested systems while …show more content…
As we move into value-based models, many of our team members need the empowerment and flexibility to make decisions without higher-up approval. Creating this culture in our current environment with current staffing issues poses a difficult endeavor. Consistency in our operations and training are required for improved decision-making. Deeper understanding of the new reimbursement models is a necessity in good job performance.
With the many regulatory changes and uncertainties occurring in the health care industry at this time, the requirements for physician practices are overwhelming. The new criteria for value-based payments places a huge reporting burden on practices. Our organization is transitioning to the patient-centered medical home (PCMH) model and is currently in the process of obtaining certification from the National Committee for Quality Assurance (NCQA). This requires buy-in and understanding from all providers and staff. Providers feel frustrated and burned out while the support staff is over-burdened in an already under-staffed environment.
We are forced to add three to four new full-time equivalents (FTEs) primarily for the PCMH transition for patient care along with EMR reporting responsibilities. The new personnel have a higher grade level of education along with the capacity for understanding many confusing criteria and regulations for PCMH
The physician-owned practice exists in an evolving market, which traditionally did not require highly skilled positions apart from the medical providers but now necessitates extensive skills from all medical and support staff. As reimbursement migrates from fee-for-service to value-based models, practices are forced to hire and train employees in new, untested systems while …show more content…
As we move into value-based models, many of our team members need the empowerment and flexibility to make decisions without higher-up approval. Creating this culture in our current environment with current staffing issues poses a difficult endeavor. Consistency in our operations and training are required for improved decision-making. Deeper understanding of the new reimbursement models is a necessity in good job performance.
With the many regulatory changes and uncertainties occurring in the health care industry at this time, the requirements for physician practices are overwhelming. The new criteria for value-based payments places a huge reporting burden on practices. Our organization is transitioning to the patient-centered medical home (PCMH) model and is currently in the process of obtaining certification from the National Committee for Quality Assurance (NCQA). This requires buy-in and understanding from all providers and staff. Providers feel frustrated and burned out while the support staff is over-burdened in an already under-staffed environment.
We are forced to add three to four new full-time equivalents (FTEs) primarily for the PCMH transition for patient care along with EMR reporting responsibilities. The new personnel have a higher grade level of education along with the capacity for understanding many confusing criteria and regulations for PCMH