Health Care Revenue Sources

Health Care Revenue Sources

Introduction

Sustainable health care organizations today need to balance the clinical and fiscal facets of the operation. People at all levels in a health care organization need to understand how the organization makes money (accounts receivable) and how it chooses to allocate or spend these resources (accounts payable).

Early careerists in a health care organization may participate in any or all of the following financial activities:

· Evaluate existing and new health care service lines.

· Develop a departmental budget.

· Provide input to strategic planning or finance department meetings.

Mid-level or advanced careerists may be asked to:

· Evaluate higher-level organization financing options.

· Anticipate cash flow needs.

· Present financial information to the CEO and board.

For the purpose of this assignment, assume you are a manager in a health care organization. Your organization likes to educate employees about the organization’s fiscal operations from the very start—at new hire orientation. You have been asked to conduct a 30-minute presentation at new hire orientation that addresses the organization’s three types of revenue sources: Medicaid, Medicare, and managed care.

Instructions

The PowerPoint presentation you create will contain between 15–20 slides. For one of the studies for this assignment, you conducted independent research on Medicare, Medicaid, and managed care. You will be incorporating this information into your presentation. You will also be expected to record your presentation using Kaltura media or your own device.

Please be sure to address all of the following headings and answer all of the questions underneath each heading in your presentation:

Introduction: Health Care Revenue Sources—Medicare, Medicaid, and Managed Care (2–3 slides)

· What are the three main types of health care revenue sources?

· Note: Find ways to engage your audience in the first few minutes of your presentation. Can you open with a startling statistic or a compelling quote or question? Feel free to be creative when labeling your slides.

Medicare (3–4 slides)

· What is Medicare’s purpose?

· What benefits do Medicare program participants receive?

· What steps do health care organizations take to be reimbursed for the Medicare services they provide?

. Consider creating a flow chart to illustrate the major steps in the process.

· What challenges do health care organizations face in terms of reimbursement?

· What data and/or quality metrics does the organization need to provide for reimbursement?

· How long does it take to receive reimbursement?

Medicaid (3–4 slides)

· What is Medicaid’s purpose?

· What benefits do Medicaid program participants receive?

· What steps do health care organizations take to be reimbursed for the Medicaid services they provide?

. Consider creating a flow chart to illustrate the major steps in the process.

· What challenges do health care organizations face in terms of reimbursement?

· What data and/or quality metrics does the organization need to provide to be reimbursed?

· How long does it take to receive reimbursement?

Managed Care (3–4 slides)

· What is managed care’s purpose?

· What benefits do managed care program participants receive?

· What steps do health care organizations take to be reimbursed for the managed care services they provide?

. Consider creating a flow chart to illustrate the major steps in the process.

· What challenges do health care organizations face in terms of reimbursement?

· What data and/or quality metrics does the organization need to provide for reimbursement?

· How long does it take to receive reimbursement?

Conclusion (2–3 slides)

· What key information do you want new hires to retain from your presentation?

. Consider creating a grid or job aid that highlights critical information about each revenue source all in one place.

· How can you close your presentation in a memorable way?

Practice and Record Your Presentation

· After preparing your slides and speaker notes, practice delivering your presentation. Do not simply read your PowerPoint slides. Instead, present your slides as if you had an actual group of new hires in the room with you. How would you present the information to them in a memorable way? Remember the more interactive you can make your presentation, the more engaged your audience will be. You can pause or edit Kaltura audios; however, editing capability is limited. Practice will help you sound professional.

· Record your presentation using Kaltura media or your own device. Consult the Using Kaltura guidelines for additional information.

. Note: If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact Disability Services to request accommodations.

· Listen to your audio prior to posting to ensure it is loud enough.

· Upload your slides, speaker’s notes and recording to the assignment area.

Submission Requirements

· Written communication: Your slides need to include bullet points highlighting the key concepts. As a best practice, each slide should contain no more than 5–7 bullet points and no more than 5–7 words per bullet point. Use speaker notes to include additional information. Appropriately balance text and visuals. Make sure your content is clear, persuasive, well-organized and free of errors in grammar, punctuation, and spelling.

· Title slide: Develop a descriptive title for your presentation of approximately 5–15 words. It should stir interest, yet maintain professional decorum.

· Length: Approximately 15–20 slides; 30-minute recording. Use Kaltura to upload your recording to the courseroom, or provide a working link your instructor can access.

· Font and font size: Appropriate size and weight for presentations, generally 24–28 points for headings and no smaller than 18 points for bullet-point text.

· Reference slide: Include a minimum of three citations to current scholarly and or authoritative sources in a final reference slide. These sources need to be from your independent research, over and above the resources provided to you in the unit studies. Current means they can be no more than five years old.

· APA format: Ensure in-text citations and references adhere to APA format. For an APA refresher, consult the APA Style and Format page on Campus.

· Scoring guide: Review this assignment’s scoring guide so that you understand how your instructor is going to evaluate your work.