Date of Award

5-8-2017

Degree Name

Nursing (D.N.P.)

Department

College of Nursing

First Advisor

Karen Burritt

Second Advisor

Cynthia Coviak

Third Advisor

Sonya Christensen

Abstract

The notion of delivering value-based care while maintaining corporate vitality in health care is a multifaceted process. Shaping a business model to reflect this process requires the alignment of quality implications, reimbursement initiatives, a framework that takes into account stipulations on reimbursement for different types of clinicians, and an understanding and preparedness for emerging guidelines and nationally recognized structures for quality indicators. When organizations recognize the need for change, but are not yet prepared to implement it, a comprehensive business plan can help the organization visualize a path to success. In this project, the foundation of requirements for a value-based business plan as described above was developed for a small home-based primary care practice in southwest Michigan. This project provided a pathway for preparation and compliance with the 2017 Medicare Merit-Based Incentive Structure. Compliance with the Medicare program has potential to improve the quality of care delivered and bring significant financial benefits if done well. As a result of this project, the home-based primary care service in southwest Michigan was considering the possible adoption of 29 new quality initiatives for the year 2017 and unlocked a potential gain of $134,000 from Medicare over succeeding next four years.

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