Overview

In this assignment, you consider a scenario in which you are asked to compare U.S. government and private sector health care financing models.

Scenario

The hospital board of directors has made a request for you to provide and present a report to them on government and private sector healthcare financing models. As part of the report, the board of directors has asked you to also provide an overview of the types of Medicare policies and provider incentives for pay for performance. As part of the report, you have been tasked with completing two parts of the report.

Your report should include the following information:

• A table that compares a government and private sector healthcare model.
• A 300-word summary on the types of Medicare policies (e.g. scope of the program, insurance premiums, managed care and competition, and provider payments) and provider incentives for pay for performance.

Instructions

Consider the scenario and complete both parts of this assignment using the Week 8 Assignment Template [DOCX] Download Week 8 Assignment Template [DOCX]for comparison of the government and private sector health care financing models. Complete the template using your own words and write a 300-word summary on the types of Medicare policies and provider incentives for pay for performance below the table. Three creditable sources are required for the assignment

Part 1: Comparing Health Care Models

In Part 1 of this assignment, you will compare the cost, access, reimbursement, and quality of government and private sector models. Choose one government and one private sector model from the list below and begin your research.

• Government
  • Medicare.
  • Medicaid.
  • Veteran’s Administration.
• Private Sector
  • Employer Provided Insurance.
  • HMO.
  • PPO.

One of the characteristics that you will consider—quality—should be assessed using the Centers for Medicare and Medicaid Services (CMS) Quality measures. Optional resources to aid your assessment can be found at:

• National Impact Assessment of the Centers for Medicare & Medicaid Services (CMS) Quality Measures ReportsLinks to an external site..
• Quality Measures: How They Are Developed, Used & MaintainedLinks to an external site.
• HEDIS Measures and Technical ResourcesLinks to an external site..

Part 2: Summary of Medicare Policies and Provider Incentives for Pay for Performance

In Part 2 of this assignment, you will write a 300-word summary on the types of Medicare policies (e.g. scope of the program, insurance premiums, managed care and competition, and provider payments) and provider incentives for pay for performance.