ASSIGMENT

Description

Supply of Primary Care Workforce

Note: Before completing this Assignment, please familiarize yourself with the Week 2 Assignment Rubric, located in the Course Information area of the course navigation menu.

To deliver healthcare services, an ACO needs to create a competent workforce that can provide healthcare to the patients that are in the ACO. Some integrated ACO entities already have employed physicians and mid-level providers that receive salaries from the organization, whereas other non-integrated ACO entities need to invest in external relationships with independent physicians and other providers. Since ACOs do not have managerial control over non-employed providers, additional controls and incentives may be necessary to ensure that efficiency is maximized. ACOs also need to consider the number and mix of specialists (e.g., family practice vs internal medicine) and mid-level providers (e.g., physician assistants and nurse practitioners) in delivering primary care services that can promote value. Maximizing value requires appropriate workforce decisions on supply and incentives to encourage providers to minimize costs. For this Assignment, you will examine the Week 2 Assignment document and consider the efficiency in the supply of health services. (Note: The Instructor will post the document for this Assignment by Day 1 of Week 2.)

Resources

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCE

To prepare for this Assignment, first review the following resources:

• Zelman, W. N., McCue, M. J., Glick, N. D., & Thomas, M. S. (2014). Financial management of health care organizations: An introduction to fundamental tools, concepts and applications (4th ed.). San Francisco, CA: Jossey-Bass.
  • Chapter 13, “Provider Payment Systems” (pp. 579–616)
• Baicker, K., & Levy, H. (2015). Cost sharing as a tool to drive higher-value care. JAMA Internal Medicine, 175(2), 399–400.
• Khullar, D., Chokshi, D., Kocher, R., Reddy, A., Basu, K., Conway, H., & Rajkumar, R. (2015). Behavioral economics and physician compensation—Promise and challenges. New England Journal of Medicine, 372(24), 2281–2283. Retrieved from http://www.nejm.org/doi/full/10.1056/NEJMp1502312
• McClellan, M. (2015). Accountable care organizations and evidence-based payment reform. Journal of the American Medical Association, 313(21), 2128–2130.
• Iglehart , J. (2014). Meeting the demand for primary care: Nurse practitioners answer the call (Expert Voices in Health Care Policy Report). Washington, D.C.: National Institute for Health Care Management. Retrieved from http://www.nihcm.org/pdf/Meeting-the-demand-for-pr…

Then review the scenario given by your Instructor (Week 2 Assignment document). Based on the financial data, conduct a financial projection (revenues, expenses, and profit) on which pay model (salary vs. fee-for-service) yields higher net profit.

By Day 7, submit a cohesive Word document that includes:

The Assignment

• Tables and/or calculations required to show your financial projection.
• Your recommendations on the following: 1) number of physicians and nurse practitioners (assume an equal number of physicians and nurse practitioners); 2) reimbursement method: salary or fee-for-service; 3) recommendations for financial incentives to address challenges of supplier-induced demand and ensure efficiency.
• Your interpretation of the net profit from the ACO contract based on your recommendations.

Be sure to support your recommendations with rationale, including how the financial calculations guided your recommendations.