Sample Solution

Care for Joint Replacement (CJR) did, but it may not generate the same level of savings as CJR has.3 The greatest challenges with BPCI Advanced will be associated with new outpatient episodes, as previous BPCI models focused solely on inpatient episodes.4 Overall, there is significant opportunity to incentivize providers to decrease costs and improve quality for some of Medicare’s most common and most expensive clinical episodes, but implementation strategies must address challenges in order to optimize the success of this VBP model.
Key lessons learned in implementation from other payment models include the placement of risk on providers to increase financial savings and risk adjustment beyond the primary diagnosis; and the allowance of waivers for services not typically covered under Medicare, such as skilled nursing facility (SNF) care without 3-day hospital stay, telehealth coverage in all geographic areas; and post-discharge home visit waivers without direct physician supervision.2,4 In addition, BPCI Advanced will ensure payments are linked to quality measures, which did not happen in previous iterations of BPCI as well as utilize more specific measures for quality universally and per episode type.4 All of these will incentivize providers to maximize financial savings and to focus on improving healthcare quality for its Medicare patients.

2. In the US, the allocation of government funding for public health vs. health care delivery vs. scientific research has been the topic of intense debate. Using two (2) public health programs (or agencies) as examples, discuss trends in financing for public health vs. health care delivery vs. scientific research; politics and policies (e.g., legislative actions) that have influenced those trends; and evidence that supports or contradicts calls to increase financing for public health. Predict whether financing for public health will increase/decrease/remain flat in the current environment; provide a rationale for your prediction.

In the U.S., there has been a significant decrease in money allocated for public health initiatives and healthcare delivery, and an increase in budget allocations for scientific research. More