Guidelines for Touchpoint Reflections

A downloadable version of the guidelines, which includes further information, is available for access on the Course Resources page.

Reflection Information

Understanding how your organization is reimbursed for services depends on several components. Assess your organization and identify its care delivery system and payer mix make up. Include percentages represented by each payer group. Use the table to record your findings.

Your Name’s Healthcare Organization

Healthcare Delivery System (Type)

Payer Mix

Percentage

Medicare

Medicaid

Managed Care

HMO

PPO

IPA

Self-pay

Uninsured

REFLECTION

Based on this data, discuss the assumptions that could be made about the population demographics for your institution. What influence do these variables have on the types of services offered at your facility?

IMPLICATIONS FOR THE FUTURE

What might your analysis tell you about the long-term health of your community?

What future needs might be identified?

Solution:

The Kaiser Permanente is a non-profit making healthcare organization that uses an integrated healthcare delivery system and is also an insurance provider. Its uses a single payer mix in that Kaiser Physicians and facilities deliver services to only those with insurance coverage with Kaiser via government (Medicare) or an individual group (employer) plan regardless registration with other insurance coverage (Khatod, 2018). The percentages of the payers in Kaiser Permanente are unique in every patient depending on the care plans one is in, the care provided and the provider seen. The assumptions by Keiser Permanente have it that the all patients should seek for medical services from a single payer with integrated care to ensure delivery of quality care, accessibility and affordability of healthcare services. For patients not near Keiser Permanente, depending on the policy guidelines on reimbursements, can receive reimbursement…..Please click the Paypal icon below to purchase full solution for only $5