Healthcare- Physician Reimbursement- Please follow Instructions

Healthcare-Physician Reimbursement
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Abstract
The essay has two parts; the first one assesses the existing forms of physician reimbursements in the nation. Specifically, the article looks at the four models in this first section; salary, fee-for-service, equal share and finally pay-for-performance. All the models have unique characteristics that the payer puts into consideration before depositing the facility. In the second part of the essay, the paper looks at the recommendations made by the National Commission on physician payment. There are twelve recommendations, but for the sake of the discussion, the analysis concentrates on three. The assessed include numbers six, five and four in that order. The essay considered the three options since they have been cited as the best examples of reforms needed in physicians reimbursement. All the necessary information on each recommendation highlighted is discussed with an additional point of view on each. In each of the three proposals, I supported the reforms suggested since the advantages of possible outcome would be immense.
Keywords: pay-for-performance, Fee-for-service, Physicians, Pay-for-performance, reforms, recommendations.

Healthcare-Physician Reimbursement
Physician Reimbursement
There are various forms of standard physician reimbursement models used in healthcare across the country. Of all the methods, the first commonly known is salary model described by Lischko (2014) as one of the most straightforward models of all the four.

The method is a contractual arrangement aimed at compensating the physicians depending on the performance level. The next way is known as fee-for-service, one of the oldest forms in the nation. Under the model, the payer negotiates with the physician-specific charges for the services rendered. A third standard method is an equal share model which is popular among physicians working in a group. The model dictates that the reimbursement is carried out after calculating the revenue, and money shared equitably among the physicians depending on shares or input in a given operation. In other words, the physicians contribute the almost equal amount of money hence the equitable distribution of the income. Finally, the most recent model that came up is known as pay-for-performance (P4P). P4P dictates that a payer provides a financial incentive to the physician depending on the quality and efficiency performed measured by the outcome of the procedure (Petersen et al., 2017). The P4P initiative came into effect to reduce any possibility of overpayment by the insurance companies.
Three Recommendations
National Commission of Physicians Payment Reform was formed with the aim of reforming the means of payment and how much physicians take home from the payer. The commission came up with recommendations aimed at reforming the payment system for the physicians. The committee suggested reforms to the existing physician payment with the intention of minimizing the adverse outcomes while maximizing on the positive for both the patient and the physicians. The recommendation number six, fee-for-service contracts must have quality measure metrics as a measure of the reimbursement rate, is a positive move in eliminating exploitation. The quality metrics would ensure that the payer gets the best out of the contract and the physician also receives an amount consummate to the service rendered. Initially, some payers give a lot of money for less or vice versa. I agree with the recommendation since it adds value to both the physician and the payer.
The fifth recommendation suggests the elimination or relocation of low-cost procedures performed in high-cost facilities as these burdens the payer. Recently a trend developed in which physician would charge a lot of money for the process performed in facilities owned by hospitals than the same service provided in an office. The reform aims to remove this form of exploitation for the payer, for instance, a study done by the Medicare found that for a simple procedure like echocardiogram they pay more than double if the performance takes place in hospital as opposed to the office (Rowland & Salganicoff, 1994). I, therefore, agree with the removal of some minor systems from colossal hospital to cut the cost incurred if the same process can be done correctly in an office or facilities that do not charge a lot. Finally, I agree with the third recommendation which calls for a recalibration of fees-for-service payment as the industry moves to a different kind of payment. The reform would favor the payer as it shifts gradually to a more sustainable method (Mechanic& Altman, 2009). Over the years, the payers blame fee-for-service for overcharging.
Conclusion
In a few words, to enhance patients’ satisfaction and empower the physician, it is essential to make reforms to the traditional means of payment. As is evident in the discussion, medical facilities would take a lot of money from the payer, private or public, for services that cost way cheaper with the implementation of the reforms.
References
Lischko, A. M. (2014). Physician payment reform: a review and update of the models. Discovery-ss student e-journal. Vil. 1. 2014.
Mechanic, R. E., & Altman, S. H. (2009). Payment Reform Options: Episode Payment Is A Good Place To Start. Health Affairs, 28(2), w262-w271. doi:10.1377/hlthaff.28.2.w262
Petersen, L. A., Ramos, K. S., Pietz, K., & Woodard, L. D. (2017). Impact of a Pay-for-Performance Program on Care for Black Patients with Hypertension: Important Answers in the Era of the Affordable Care Act. Health Services Research, 52(3), 1138-1155. doi:10.1111/1475-6773.12517
Rowland, D., & Salganicoff, A. (1994). Lessons From Medicaid – Improving Access to Office-Based Physician Care for the Low-Income Populations. American Journal of Public Health, 84(4), 550-552.