Accountable care organization payment and bundled care payment
Write 400–600 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas.
Due to decreased funding caused by value based models of payment, accountable care organization payment and bundled care payment, discuss the following:
What is the impact that these new payment models will have on Krona’s revenue?
Address the possible issues surrounding next year’s forecasting.
Discuss the challenges, benefits, and risks in utilizing capitation.
Sample Solution
The recent shift towards value-based models of payment, such as Accountable Care Organizations (ACOs) and bundled care payments, has had a significant impact on Krona’s revenue. These new payment models focus on providing outcomes that improve the quality and efficiency of patient care rather than paying for volume or services provided, which reduces the overall cost to payers while improving health and satisfaction outcomes (Hartung et al., 2018). As a result, providers are incentivized to reduce costs associated with unnecessary services, resulting in decreased reimbursement rates for Krona.
In addition to reduced revenues from these value-based payment models, there is also an increased administrative burden associated with them. To receive reimbursements under ACO contracts or bundled care payments, providers must first meet certain standards and criteria set by the payer in order to qualify (National Association of ACOs [NAACOS], 2020). This requires additional time spent documenting services rendered as well as more meticulous record keeping practices all at an increased cost. Thus far these requirements have proven costly for Krona leading to further declines in their overall earnings.
