Centers for Medicare and Medicaid Pay-for-Performance Presentation Instructions:
Imagine that you are an administrator for a large hospital. As part of your role within healthcare leadership, you are involved in several committees for the organization. For this Assignment you are requesting funding from the Board of Directors for an investment of a new electronic health record (EHR) system.
Create one summary, on a Word document, which delivers each of the 4 parts of this assignment. When combined this summary should fully support your funding request, by analyzing the impact a new EHR would have on the hospitals revenue and reimbursement, on data collection, operations, and relationships both internal and external.
Part
Competency Assessed
Instructions
1
Apply principles of healthcare finance for revenue management.
Task: In preparation for your funding request, you have scheduled a meeting with the department managers to present your proposal. In this meeting, demonstrate the principles of healthcare finance for revenue management through the intended application of cost reporting and variances. Create a summary for department managers which covers the pros of investing in a new EHR. Include in your summary how the EHR will address topics of cost reporting and the variances seen currently. In addition, include a budget speculation in your summary.
2
Implement processes for revenue cycle management and reporting.
Task: Knowing that the Board of Directors will need to consider the implications of adopting a new EHR system on the information systems related to RCM and reporting, you will analyze and present three (3) major considerations found in the following areas:
• Corrective Coding Initiative (CCI)-Electronic Billing X12N
• Compliance strategies and reporting
• Audit process (compliance and reimbursement)
• Revenue cycle process
• Utilization and resource management
3
Identify severity of illness and its impact on healthcare payment systems.
Task: As part of your analysis on the implications of a new EHR system on other information systems, analyze the relationship between data quality within a new EHR and severity of illness. Identify the purpose and use of severity of illness based on information within the health record. Conclude this section of your summary by associating severity of illness and healthcare payment systems, integrating case-mix and CAC systems.
4
Identify the different types of organizations, services, and personnel and their interrelationships across the health care delivery system.
Task: Funding request summaries often become available to the general public–either on its own or when combined into another report. Identify and discuss the connections among the different types of organizations, services, and personnel–including their interrelationships across the health care delivery system. To do this, analyze the implications of a new EHR system with the hospital systems\’ operations with ACOs and MCOs. Additionally, include the implications related to medical devices / biotechnology.
