Assignment 4 - Individual Weekly Assignment

Provide fact-based answers to the questions below:

Chapter 6

1. What are the various mechanisms for healthcare reimbursement? Explain 3 types in detail.

2. How did the original Affordable Care Act change individual medical coverage? 

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Reimbursement for healthcare outlines the payments that healthcare providers, the hospital, diagnostic facility , or other providers of health services receive for providing medical services to you. Healthcare re imbursement deploys various mechanisms which differ in their levels of effectiveness (Garrison & Towse, 2017) . The main aim of healthcare mechanisms is to improve the overall quality of healthcare. Healthcare organizations need to ensure that these mechanisms are accurate and efficient so as to provide quality healthcare. Such mechanisms are described below

Fee-for-service is one of the healthcare reimbursement mechanisms. This mechanism includes certain negotiated rates regarding every procedure and service performed where care-management elements and overtime have also been included. This model gives the patient an opportunity to price the cost of each personal product or service that the doctor orders (Garrison & Towse, 2017) . The bill comprises these services and products as well as their prices indicated for the patient or the insurance payer. However, this can result in service inflation, unnecessary testing, billing errors , and treatment redundancy.

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