Healthcare Reimbursement: Strategic Reimbursement Design and Model Alignment

$15.00

Format: On demand

Duration: 150 Mins

Instructors: Coral MED

Learning Credits: 0.2 CEU

*This course was updated on Jan 01, 1970.

Description

This unit enables learners to synthesize and critically compare the major healthcare reimbursement models covered in the module. Learners evaluate the design, financial incentives, clinical impacts, and operational trade-offs of payment systems including Fee-for-Service (FFS), Capitation, Bundled Payments, Pay-for-Performance (P4P), and Accountable Care Organizations (ACOs). Emphasis is placed on applying strategic thinking to determine how each model aligns with specific organizational goals, patient population needs, and policy objectives. Learners engage in scenario-based decision-making activities that simulate selecting appropriate payment models for varied healthcare environments. Using comparison matrices and policy frameworks, participants assess models across criteria such as financial risk, quality alignment, care coordination, and administrative complexity. The unit also introduces hybrid or blended payment models, examining how organizations innovate by combining elements from multiple reimbursement approaches. By integrating financial reasoning and quality improvement principles, learners develop a comprehensive understanding of how payment design influences healthcare performance and sustainability.

Summarize characteristics of FFS, Capitation, Bundled, P4P, and ACO models. Compare incentives, risks, and outcomes for each model. Identify alignment of models with organizational goals. Analyze how model choice affects provider behavior and patient experience. Evaluate suitability of models for various care settings. Discuss suitable payment models based on a scenario.

Upon completing this unit, learners: Demonstrate comprehensive understanding of the major healthcare reimbursement models and their interrelationships. Apply comparative frameworks to assess payment model strengths, weaknesses, and applicability. Evaluate how different payment systems affect cost management, quality performance, and care coordination. Formulate evidence-based recommendations for payment model selection and reform. Synthesize analytical, financial, and strategic thinking to support organizational decision-making in reimbursement strategy. Communicate informed perspectives on payment reform to diverse healthcare stakeholders.

Completion of Unit Course on: Accountable Care Organizations (ACOs) and Population-Based Payment is recommended. Learners should have prior exposure to value-based models, risk-sharing principles, and performance measurement before engaging in comparative payment analysis.

Follow Coral Plus LMS policies: participation, integrity, respectful conduct, HIPAA/privacy adherence, timely completion of assessments. 1. Participants should register in advance to receive access details. 2. Access links and passwords, if applicable, should be provided securely to registered participants. 3. Participants are encouraged to join the webinar a few minutes early to resolve any technical issues 4. Participants are responsible for ensuring a stable internet connection, compatible devices (computer, tablet, or smartphone), and recommended browsers. 5. A microphone and webcam may be required for interactive sessions. Please test your audio and video settings in advance. 6. The webinar may be recorded for educational purposes. 7. Recorded sessions may be shared with registered participants after the webinar. 8. Please be mindful not to share personal or confidential information during the webinar. 9. A detailed agenda will be provided, and each session will adhere to the schedule to cover all planned topics. 10. Time will be allocated for Q&A sessions and discussions. 11. A helpdesk or contact information for technical support will be provided during the webinar. 12. Common technical issues will be addressed at the beginning of the session. 13. Relevant resources, such as presentation slides or additional reading materials, will be shared after the webinar. Proprietary Interest Policy: It is the policy of Coral MED that if instructors have a vested interest in any product, instrument, device, or materials that may be used in the learning event, they must disclose this interest. Further, if the instructors receive any share of the royalties or profits from the product promotion or endorsement, the interest must be disclosed to the learner. If there are any breaches of this policy, please contact Coral MED at +1 (808) 913-7979 OR send an email to compliance@coralmed-inc.com Anti Discrimination Policy: Coral MED is committed to providing work and learning environments free of sexual or any form of unlawful harassment or discrimination. Harassment or unlawful discrimination against individuals on the basis of race, religion, creed, color, national origin, sex, sexual orientation, gender identity, age, ancestry, physical or mental disability, medical condition including medical characteristics, marital status or any other classification protected by local, state or federal laws is illegal and prohibited by Coral MED policy. If there are any breaches of this policy, please contact Coral MED at +1 (808) 913-7979 or send an email to compliance@coralmed-inc.com 6) Privacy & Data Protection Policy Coral MED values the privacy, security, and integrity of your learner records. Your information is managed in accordance with Policy CM012 – Learner Records Privacy and Data Security Policy, which complies with applicable data protection laws and accreditation standards.How to Request the Release or Correction of Your Records If you wish to obtain, release, or correct your learner records, please follow these steps: 1. Submit a written or electronic request to: elearn@coralmed-inc.com ↗ . 2. Include your full name, learner ID, and specific request type (e.g., transcript, name correction, verification letter). 3. Requests are processed within 10 business days of verification. 4. You will receive an email confirmation once your request has been fulfilled. Notification of Record Availability Upon completion of a learning event, Coral MED notifies learners via email when official records (e.g., transcripts, certificates, or CEUs) are issued or available for download within the LMS. You may review the full policy at any time by visiting:. View Policy ↗

This unit benefits healthcare administrators, quality improvement managers, and healthcare consultants involved in payment model selection and reform strategy. It is particularly valuable for professionals responsible for payer-provider negotiations, strategic planning, or reimbursement design. Learners develop the ability to evaluate models holistically balancing financial sustainability, quality outcomes, and equity to guide healthcare organizations in aligning reimbursement structures with system-wide performance goals.