Versus Value-Based Reimbursement (3
Variants)
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Models of payment to healthcare organizations have begun to shift … from paying for volume
(fee for service) to paying for value (quality). Using a Venn Diagram, compare volume-based
versus value-based reimbursement. Be sure the overlapping area contains … the commonalities
between the two systems.Use the editable template for the Venn Diagram, which is_ available for
download above. This_ template (with your findings) will need to be posted as an attachment in
your dis_cussion post along with your written prompt.
Consider Jim, who is_ 69 years old and comes to your Emergency Department (ED) with severe
abdominal pain. His_ evaluation, besides a physical exam, includes an abdominal ultrasound, a
CT scan with and without contrast, multiple lab studies, all lead to his_ having an emergency
appendectomy. Other than having Type II diabetes well … controlled on diet and exercis_e, he
is_ in otherwis_e good health. Jim is_ … as an outpatient and is_ … home the next morning.
Two weeks later he returns to the ED with fever, continued abdominal pain, and a surgical site
infection. He is_ … for 5 days before … home.
Using your findings from your comparis_on of volume- versus value-based reimbursements,
analyze the scenario. Determine how the hospital could charge and … reimbursed using the two
methods. In this_ case, which would be … better for the hospital? How do each of these payment
models contribute to or detract from the goal of the Triple Aim? Considering payer mix, delivery
systems, population demographic, and value-based purchasing of the institution. How do all of
these elements influence the financing of the type and quality of care provided at your facility?
What are the implications on access and availability of types of care provided by your
institution?
Remember to support your thoughts with scholarly sources.
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