Overview: In terms of reimbursement and financial principles (specifically relating to the revenue cycle), you will determine what federal and state funding is
available for healthcare organizations. As you continue to explore payment systems from the view of the hospital administrator, consider what actions you might
take to ensure your facility meets compliance requirements. Additionally, you will research the importance of implementing policies and procedures that are
designed to ensure timely reimbursement.
Prompt: Submit a draft of the Federal and State Payment Systems portion of your research and analysis. Be sure to address all critical elements as listed below.
Specifically, the following critical elements must be addressed:
III. Federal and State Payment Systems:
a) Federal and State Regulations: Considering the recent changes in economic policy at the federal and state levels, what changes in federal and state
regulations present the most concern for healthcare leaders? Be sure to provide support for your response.
b) Reporting Requirements: Analyze the reporting guidelines required by Medicaid and Medicare and other government payment systems. What are
the opportunities and challenges for healthcare leaders in meeting reporting requirements?
c) Compliance Standards and Financial Principles: Analyze how healthcare organizations in general utilize financial principles to ensure compliance
with government standards.
d) Government Payer Types: Considering Medicaid, Medicare, and other government payer systems, what strategies would you recommend
organizations implement in order to receive full reimbursement on claims as well as to improve timeliness of this reimbursement? Be sure to justify
your recommendations.
Rubric
Guidelines for Submission: Your draft of the Federal and State Payment Systems portion of your research and analysis should be 2 pages in length and should
be double-spaced in 12-point Times New Roman font with one-inch margins. All citations and references should be formatted according to current APA
guidelines. Include at least two references.
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