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The four types of reimbursement schemes
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Direct and Limited reimbursement plans are tactics associated with handling expenses associated with sales. These expenses could include meals, travel, hotel, and other expenses associated with entertaining clients. Direct reimbursements involve unlimited reimbursement of all allowable and reasonable expenses. The advantage of direct reimbursements is that direct reimbursement plans give the sales manager some control over both the total magnitude of sales expenses, and the kinds of activities salespeople will be motivated to do. Limited reimbursement plans limit the total amount of reimbursement expense either by setting limits for each expense or by providing each salesperson a predetermined lump-sum payment to cover total expenses. Reimbursement
It is generally accepted that the method of payment to physicians affect their professional attitude and behaviour. Consequently, health policy makers manipulate payment system in an attempt to achieve optimal health care for their citizens such as improve accessibility, quality of care, patient’s satisfaction and cost containment. In Ontario, there are a wide range of mechanisms that are used to pay physicians for their services that are funded by both federal and provincial government. According to Canada Health Act annual report (2013), the majority of primary healthcare physicians are funded using the fee for service payment arrangement but of that majority, only less than 30% are compensated exclusively according the fee for service plan. The remaining physicians are funded using one of the following mixed compensation models:
TQL can put a single sales supervisor into place and divide teams and appoint team leaders immediately. Due to the lack of managerial experience among the account executives the Executive Sales Managers may wish to hold the sales supervisor position until a manager can be placed and properly trained. During this time, non-montary methods of rewards should be discussed for the team leaders duties. TQL should start low and move up with rewards based on performance as a team leader. Some may currently act as an unofficial team leader and may not expect significant reimbursement and TQL should take advantage of these persons.
The IPPS or the inpatient prospective payment system refers to a system of payment which includes the diagnosis-related groups’ cases as acute care hospital inpatients. This system is based on resources which are utilized when treating Medicare recipients belonging to these groups. Each diagnosis-related group (DRG) comprise of a payment weight. The IPPS serves an integral role when it comes to deciding the overall hospital costs of all the devices used to treat the patient in within a specific inpatient stay.
Medicare part A payment reimbursement is done through a Prospective payment system (PPS). Under the PPS Medicare payment is based on a predetermined, fixed amount. In order to determine the payment amount for a particular service different classification systems are used based on setting type 6. In fact, Centers for Medicare & Medicaid services (CMS) use separate PPSs all together for reimbursement to acute inpatient hospitals, home health agencies, hospice, hospital outpatient, inpatient psychiatric facilities, inpatient rehabilitation facilities, long-term care hospitals, and skilled nursing facilities 6. Since implementation of the PPS to each of these settings, healthcare providers (i.e. Physical Therapists) have faced many challenges.
In recent times, healthcare organization across the nation are facing unprecedented challenges as they strive to improve the overall quality of care provided to their patient’s population, while improving their organization’s financial performance. Furthermore, uncertainty of new reimbursement models, diminishing reimbursement, and complicated compliance regulations are playing the role of a catalyst for streamlining the Chargemaster process in majority of healthcare organizations.
A multispecialty group practice is one that consists of individual physicians who offer various medical and specialty services in that practice by contracting to a managed care plan. Managed Care Organizations are formed by insurance companies that either own a provider network or create one by arranging with independent providers (Gapenski, 2009). The payment structure used to reimburse providers regardless of services provided falls into the category of either fee-for-service or capitation based. Fee-for-service is the reimbursement according to services provided, either through reimbursing based on the cost of services provided or reimbursing based on rate schedule of services provided. On the other hand, in the Capitation system, providers are paid a fixed amount depending on the number o...
Pay-for-performance (P4P) is the compensation representation that compensates healthcare contributors for accomplishing pre-authorized objectives for the delivery of quality health care assistance by economic incentives. P4P is increasingly put into practice in the healthcare structure to support quality enhancements in healthcare systems. Thus, pay-for-performance can be seen as a means of attaching financial incentives to the main objectives of clinical care. However, reimbursement is a managed care payment by a third party to a beneficiary, hospital or other health care providers for services rendered to an insured or beneficiary. This paper discusses how reimbursement can be affected by the pay-for-performance approach and how system cost reductions impact the quality and efficiency of healthcare. In addition, it also addresses how pay-for-performance affects different healthcare providers and their customers. Finally, there will also be a discussion on the effects pay-for-performance will have on the future of healthcare.
The social impact of the Out of Pocket costs for medications may lead to non-compliance.
The sales leads are now centralized and accessible across branches rather than individually gathered and processed by salespeople. In standardizing customer information, it now makes the marketing teams, analytic teams, and customer managers on the same page. It creates a “friendly competition” that encourages close cooperation for all areas. One major cost that this new strategy created was the confusion of different areas in RBC. Product managers and customer managers often misunderstood what way of action was appropriate, which lead to another problem: it took more time to make decisions. A benefit of this change is that there was no fighting for resources and instead cooperation. Another benefit would be the divisional organization, which can be seen in Exhibits 3a and
In today’s ever growing workforce the job market competition is becoming increasingly higher and more difficult with each passing year. This is forcing people to go back to school and pursue an education or further expanded their education beyond an undergrad degree. Although more people are going back to school they all are not footing the bill all by them self. It is 2014 and more employers are giving the opportunity of going back to school to their employees by providing education assistance programs or tuition reimbursement. According to the Elearning Glossary on elearners.com, tuition reimbursement is defined as “An employee benefit offered by employers to fully or partially cover the costs of tuition for post-secondary or training courses” (Eleaners , 2012). When it comes to tuition reimbursement there are numerous amounts of factors a company has to plan by and employees must know to get their true worth of a company’s tuition assistance program. Employees are the only ones who see education as an investment.
The newly appointed district sales manager, Larry Barr, faces the problem of allocating sales quotas among his various sales representatives. This decision will affect everyone's earnings including his own. This problem is compounded by the fact that different territories have, for a variety of reasons, different potentials. In addition, the territory that is known to be the toughest will soon require a new sales rep.
Fee-for-service is a retrospective reimbursement system in which providers create a comprehensive list of services they provided to a patient and the materials, supplies, and facilities they used to provide those services and then bill the patient’s insurer (or the patient, if he/she is self-pay) for each item on the list (Cellucci et al., 2014). Traditionally physicians were reimbursed on a fee for service basis. In a fee for service arrangement, physicians were paid based on the numbers of services administered to the patients. Fee for service gave providers an incentive to provided more treatment because payment was dependent on the quantity of care rather than the quality of care. Some of the disadvantages of
Anderson, Erin. 1985. "The Salesperson as Outside Agent or Employee: A Transaction Cost Analysis." Marketing Science 4:234-254.
A sales manager has many responsibilities such as spreading product to customers, setting sales areas, goals, and analyzing sales data (“Sales Manager” What’s para. 1). Although a sales manager performs many duties, people in this position will also set a sales goal for the year, and will build a sales outlook on what they will do in the upcoming years (“Sales Manager” Sokanu para. 1).A person in this position will also manage where the goods and products their company will be distributing by giving certain sales area where a salesman will work and sell the product (“Sales Manager” Sokanu para. 2). During work time, a sales manager may be asked to hire and train a new salesman added to his team (“Sales Manager” Sokanu para. 3). Occasionally, a sales manager will interpret sales statistics in a specific area when looking where to assign certain salesman to a sales territory (“Sales Manager” Sokanu pa...
Sales force management tools such as quotas, targets and sales reports are mainly used by management for a number of reasons. These include monitoring of sales force performance and determining suitable target markets for their sales force. Technology is also an aspect in sales management that has revolutionized sale and management in organizations. The incorporation of new technology has made work much easier for both employees and the management.