COURSE 4 of 7. This course is designed to help you build high-level knowledge of the current medical coding and payment mechanisms of most U.S. healthcare services, referred to as fee-for-service. You will explore why the fee-for-service model has contributed to higher costs in the U.S. healthcare system without clearly improving health outcomes. You will examine the importance of coding to reflect chronic conditions and other diagnoses accurately and how value-based care and payments utilize these measures and data. As you learn about a model to replace fee-for-service, you’ll encounter a range of payment options considered to be value-based that utilize a framework from the Health Care Payment Learning and Action Network (HCP-LAN). To build on those options, you will learn how risk-adjustment, quality scores, and patient satisfaction measures are critical parts of value-based care and payment contracts. In the summative assignment, you will demonstrate your knowledge by comparing fee-for-service and value-based contracts, using specific examples to explain and justify the importance of documentation and coding, and identifying ways that risk-adjustment and patient satisfaction are incorporated into value-based care contracts. CME Accreditation The American Academy of Family Physicians (AAFP) has approved this course for Continuing Medical Education Prescribed Credits. Visit the FAQs for important information regarding 1) Term of approval and 2) Accreditation and Credit Designation statements.
MK
Its an excellent course with a lot of insights on how to develop models of reimbursement. Its very specific to the US however, and examples from other countries would be useful.
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Beginning to understand somewhat of the cope of how VBC and why the transitioning is necessary to help with the overall healthcare system and better outcomes for patients. I'm liking this VBC. Thank you.
great information
best
Overall this course effectively explained the various reimbursement models and gave some history about how health insurance began and how it has evolved into the current system we have. It is clear that the current system is unsustainable and that changes must be made. Where I have a difference in my opinion about the reasons the US health system has evolved into what it currently is. The blame is set squarely on the shoulders of the providers as the main reason for increasing costs. There is no mention made of the contribution for profit healthcare systems have had in this dysfunctional system. For example, one or the sponsors of this course Humana made a huge profits in 2021. I quote from Fierce Healthcare " In the second quarter of 2021, the insurer reported $588 million in profit for an increase of 18.4%, according to its earnings report Humana also brought in $23.7 billion in revenue for the quarter, an increase of 14.6% from the $20.6 billion reported in the second quarter of 2021. " The CEO of Humana made over $16,000,000 in 2021. The medico-legal enviornment which clearly drives up cost was not mentioned and the general societal attitude of " do every test" , expensive and uncessary end of life care among many others requires a complete shift in policies and hopefully attitudes. I feel this course contained bias that needs to addressed.
Very insightful course for professionals needing an insight and levelset into the value based payment model. The additional resources information in my case is very helpful for anyone curious to get more clarity on some of the concepts and topics introduced in the course.
I reduced 1 star as the oral narration on some of the sections of this course was way too fast. I've taken a few other courses on the value based secialization series and didnt face this issue. It will be helpful if the delivery is a bit slowed down to give the listener time to digest, comprehend and sink in the content. Otherwise, content wise loved the bases covered and makes me feel more confident about my foundational understanding of value based payments and with this foundation, I will be able to build on more knowledge from my work experiences.
Its an excellent course with a lot of insights on how to develop models of reimbursement. Its very specific to the US however, and examples from other countries would be useful.
I really liked the course and the instruction.
The peer review is a nightmare, the process of chasing people to review your assigment is time consuming and shamful.