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( 1 ) Payments for Health Services Providers Insurance is based on pooling of lo
( 1 ) Payments for Health Services Providers Insurance is based on pooling of losses, payment for random losses, risk transfer, and indemnification. As a result, insurers use several different approaches to mitigate their risk and set premium rates, including: the fee-for-service method the cost-plus approach population health – capitation For your assignment, evaluate two global payment systems within healthcare and address each of the following items: Define the structure of the payment systems. Identify risk to loss of revenue in each system. Describe advantages and disadvantages of each system. Identify how pay for performance can be added to each payment system. Requirements: Your paper should be four to five pages in length, not including the title and reference pages. You must include a minimum of four credible sources. Use the Saudi Electronic Digital Library to find your resources. Your paper must follow APA 7th edition requirements, as appropriate. You are strongly encouraged to submit all assignments to the Originality Check prior to submitting them to your instructor for grading. ( 2 ) You are a director of the quality improvement department for a large trauma center. For your department, you feel there is a need to purchase a full-scale simulation room. This simulation room would be outfitted with the latest tools and simulations for wound management, sterile surgical process, infection control, and line placements. The overall goal would be to decrease reinfection rates. The capital need for the simulation center is $500,000, with producing a decrease in cost for reinfection rates of $120,000 per year. What type of analysis do you need to do? Who are the stakeholders you need at the table? How do you create a process to succeed in getting the room purchased? Be sure to support your statements with logic and argument, citing all sources that you use. Post your initial response early and check back often to continue the discussion. You are required to reply to at least two peer discussion question post answers to this weekly discussion question and/or your instructor’s response to your posting. These post replies need to be substantial and constructive in nature. They should add to the content of the post and evaluate/analyze that post’s answer. Normal course dialogue doesn’t fulfill these peer replies but is expected throughout the course. Answering all course questions is also required.
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