Healthcare Industry Overview

The US government is one of the largest purchasers of healthcare services and because of this, they seek out opportunities to contain costs. Recent healthcare policy has focused on managing costs while offering quality care and improving access to care. The Centers for Medicare and Medicaid Services (CMS) Innovation Center develops payment and service delivery models with this in mind.
Scenario:
Mr. Magone, CEO of Healing Hands Hospital, has asked you to join the “Future of Healing Hands” Task Force. Your first assignment is to work with the Hospital Chief Financial Officer, Ms. Johnson, and provide a summary of how the new CMS initiatives might impact the organization’s revenue structure. More information on the innovation models can be found on the CMS website.

  • What is an Accountable Care Organization (ACO)?
  • What is an Episode-based Payment Initiative?
  • How would participating in an ACO model or Episode-based Payment Initiative be beneficial to Healing Hands Hospital?

Sample Solution

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