Reimbursement In Healthcare Essay

As reimbursement in the healthcare system changes, three systems or programs may be of interest when planning to facilitate population health management.
The first is telemedicine, which is defined as “the delivery of medical care independent of time and location.” Telemedicine has the potential to improve quality and access to care while decreasing costs. Cusack et al describe the potential for telemedicine to positively impact the ongoing problems in the healthcare system, including ever-increasing costs and “dysfunctional reimbursement policies.” Remote monitoring has the potential to reduce costs related to the sickest, most economically draining patients by improving continuity of care and providing improved opportunities for early intervention.

HIEs allow disparate EHR systems to communicate and allow for broader data analysis, which will be helpful as reimbursement models shift to pay-for-performance. One major initiative is the CONNECT community portal, which uses Nationwide Health Information Network standards and policies to share big data both locally and nationally. While several benefits may be realized using HIEs, barriers to adoption exist. An executive summary written by Hersh et al categorized barriers (and facilitators) of HIEs into three areas, including lack of critical mass electronically exchanging data, workflow, and interface. The first category, lack of critical mass, includes issues such incomplete or unhelpful data, issues that affect the completeness of patient data, and data that is not easily attached to a patient. Workflow barriers include who enters and access the data and how they use the information. While slow system speed is an absolute barrier in the interface category, other interface and feature issues are somewhat subjective based on who is using the system. Other barriers identified include those related to the external environment (legislative and funding constraints), lack of standards, interoperability issues, and disincentives, the mismatch between investors in HIE and those who benefit from its