(1)
What do you believe are the primary advantages and disadvantages of having multiple revenue sources for health care services offered by an organization for planning and reporting purposes?
Having multiple streams of revenue in healthcare for planning and reporting purposes is important for many reasons. One reason is that an organization does not have to rely heavily on one single service or product to ensure that the busines can continue operations. Multiple streams of revenue ensure financial stability for an organization.
Operating a healthcare facility requires a lot of labor-intensive work to ensure that all of the moving parts work together to achieve success. This also includes handling the revenue cycle of the organization which is essential to operations. Revenue Cycle Management (RCM) collects fiscal data and identifies trends that are associated with provisions for patient services. The components of RCM are clinical and administrative and are functional actions that aid in the capture, collection, and management of all of the data. This is usually done by a third-party organization to ensure that there are not issues with internal staffing. Some other advantages are:
- Lower expense – outsource RCM; this is more cost-effective than hiring an internal RCM team.
- Reduced opportunities for conflict of interest – there is an individual or an organization who is neutral to the process.
Disadvantages to having multiple streams of revenue include:
- Reduced ownership of responsibilities – Having multiple streams of revenue that prompt the need to hire third-party organizations to manage RCM will employee individuals or teams who do not have a brand affinity for the healthcare organization because they are not employees of that organization.
- Lack of engagement by third-party team to manage RCM – outsourced organizations will employee workers who usually work for several other facilities simultaneously while providing RCM management services. These organizations do not have a personal interest or connection to any one healthcare organization.
Drakic-Grgur M. (2020). Financial Management.Studies in health technology and informatics,274, 68–81.
(2)
- What do you believe are the primary advantages and disadvantages of having multiple revenue sources for health care services offered by an organization for planning and reporting purposes?
Nowadays among health care there are several different payment plans for individuals and among businesses. Today majority of health providers as well as state-provided health care providers have used retrospective, prospective and other payment plans with operating. Operating with prospective payment plans helps providers offer a fixed payment rate for certain treatments based on predetermined factors. Some of the payment rates can be adjusted periodically in account for inflation,as well as with the cost of living in certain regions or other large scale economic factors but a disadvantage is that it doesn't actually accommodate the individual patient. Although, that happens, majority of health-care providers receives the same payment for each treatment of the same type. Many healthcare treatments of the same type of service receive multiple payments, but its payment amount still stays the same way. Even though, in some cases a individual might require multiple treatments, the treatments are still segmented so that each one of the treatments can be assigned with its corresponding payment rate(Blank, 2017). Also, the fixed rates among this plan has made calculating expenditures more predictable and create more savings for many insurance companies as well. Majority of these companies that uses this plan most of the time will pass the benefits to their consumers in the form of lower premiums and co-pays regarding patients and services.Even though that sounds good, but cost-cutting measures don't necessarily account for the quality of care for the patients and all patients value the quality of the services being received with them, which can be a disadvantage.
Furthermore, Retrospective payment plans helps provide payments to health-care providers based on their actual charges. The advantage with implementing this particular payment plan is that underneath it, a health care provider treats the patient and then submits an itemized bill to its insurance provider describing the services that he or she provided. Even though, the itemized bill is sent in, the insurance provider may approve it or the company might deny the payment for certain services or towards the entire bill. Also, the provider can note it as a customary procedure in order to receive payment for the full amount that was documented on the submitted bill without dispute from the insurance company as well. Overall, using various revenue sources as payments for services can help provide a greater peace of mind for providers because most services aren't all the time covered 100 percent, then some are fully covered!
Blank, C. (2017, April 19). Prospective Payment Plan vs. Retrospective. Retrieved from, www.pocketsense.com