Discussion: Reimbursement for ServicesThere are a number of differentoptions for determining how to charge for services provided at a health careorganization. In the case-based service approach, one set fee covers an entireprocedure. For example, if you needed knee replacement surgery, the fee wouldinclude preliminary visits, the surgery, and follow-up visits. However, in afee-for-service approach, every different step would incur a separate cost. Thereimbursement approach taken has significant ramifications for how care isprovided.To prepare:Review the information in this week’s LearningResources focusing on reimbursement for services. How are these approachesthe same or different in your own setting?Identify an example of a fee-for-service approach and acase-based service approach.Reflect on the benefits and limitations of eachapproach.Review the article, “Which Health care Payment Systemis Best?” and examine the additional reimbursement strategies described.Consider the viability of these alternative strategies within your ownorganization (or one with which you are familiar).Examine how the nurse-to-patient ratio is affected bythe payment approach used and consider how this can impact quality ofservice.ByDay 3Post an example that illustrates the difference between afee-for-service payment and a case-based service payment. Explain the benefitsand limitations of each approach. Assess the viability of utilizing, withinyour own organization (or one with which you are familiar), the two alternativereimbursement strategies described in “Which Health care Payment System isBest?” Analyze how the nurse-to-patient ratio is affected by the paymentapproach selected and how these impact quality of service.
