It was also mentioned that traditional functions of utilization management created incentives for physicians and providers to increase services that may not have been medically necessary, or may have had a lower cost alternative that the patient was not informed about.
Most of you felt that communication is extremely important because managers need to be able to effectively communicate problems, agendas, expectations, and information; they also need to be someone that employees feel they can communicate with.
Managers need to be able to implement new models. The health plan managers are supposed to be knowledgeable in managerial skills, such as, interpersonal skills, analytical skills, and action skill. These skills tend to differ depending on the settings of the healthcare departments. For instance, the skills required for inpatient setup maybe completely different from those required for ambulatory and ancillary settings.
Some wrote about how a patient centered atmosphere means more attention to detail which is being taken seriously. With enough data recorded on a patient and the necessity behind certain care provided, the less likely a health plan will deny certain care. Managers will need to utilize many managerial competencies within the ever-changing healthcare world. It was mentioned that a good competency to use is adaptability. Healthcare changes more than any other organization and we live in a time of great changes due to the Affordable Care Act and cutting edge technology that is available today. Some felt that manager’s approach to inpatient vs outpatient setting would not differ. These competencies apply to any situation or setting, you just have to follow protocol/procedure in your particular setting; ensure that you adapt these competencies to your current healthcare setting and adjust them accordingly if needed. Others felt that the difference would be what type of data you would need to collect for inpatient vs. outpatient setting as there may be different measures.
Patients are also being encouraged to be hands on with feedback on healthcare provider’s services. There has also been a huge emphasis placed on the importance of accurate documentation. Using Ware housed data was also felt to be important to make clinical decisions that are cost effective. This is also helpful for predictive forecasting models of care. Cross training was also mentioned and how important this can be to keep a department running smoothly.
As a Healthcare administrator managing a VBS, how would you offset the lost revenue from less procedures being performed due to quality vs. quantity based care? With authorizations needed to approve certain procedures, less procedures are being performed. Less costly procedures are to be exhausted before performing costly procedures such as a patient going to Physical Therapy before having costly/risky surgery.
PLACE THIS ORDER OR A SIMILAR ORDER WITH NURSING HOMEWORK HELP TODAY AND GET AN AMAZING DISCOUNT
