Medical Financial definition of terms Research Paper

Medical Financial definition of terms - investigate Paper ExampleThe PMPM is used in the analysis of the parameters of the different health status of the patients. The PMPM feed remunerative to the health home care providers is determined by several factors (Wodchis, Hirth & Fries, 2007). The health home plan in the tonic York Medicaid adjusts the PMPM that is paid to the health care providers according to the enrollment volume, region, and the case mix. There are plans to arrest the patients functional status in the near future by the New York Medicaid program as one of the determinants of the consideration in paying the Health Home providers. The New York Medicaid program provides for earnings of a case finding Per Member per Month bill, which is a cheaper amount. The case finding PMPM is provided during the first few weeks of the program to cater for reimbursement of engagement and outreach services (Centers for Medicare and Medicaid services, 2011). The provisions of the Ne w York Medicaid are that the billing of active health check care management of the enrolled patients is only made when a health care manager is assigned to the patient. The New York Medicaid health home program has various managed care plans, which give the guidelines for the payment if the contracted medical professionals (Centers for Medicare and Medicaid services, 2011). ... bell of medical care in Medicaid, the capitalization is used to ensure that all medical expenses including the payment of the providers and the expenses of bribe of drugs are paid for and accounted for (Centers for Medicare and Medicaid services, 2011). Acuity chump in Case Management Medicaid The term acuity score in case management stands for the levels into which patients are assigned depending on their health status (Sparer, Brown & Cover, 1999). In Medicaid, a specified criterion is used to categorize patients into levels with point values called equity scores which genuinely according to the life a rea that the condition of the patient is allocated to. The acuity score of the patient is assigned down the stairs two life areas. These are the sanctioned and medical inescapably. Each one of the life areas has different levels with tally points or acuity scores (Sparer, Brown & Cover, 1999). According to Meade and Pope (2007), in Medicaid, the first level of the fundamental needs life area has one point and it includes various basic needs. These are sustenance items much(prenominal) as clothing and food. The Medicaid provides that the items in this level are made available through the means of the patient. The mho level in the basic needs life area has an acuity score of 4 points. The needs in this level are for the sustenance of the patient. According to the provisions of the Medicaid program, the patient should be able to pertain these needs with occasional assistance. This means that emergence assistance is not required in this level. The assistance mandatory to perform the ADL by the patient who scores 4 points is usually weekly (Meade & Pope, 2007). The third level of the basic needs life area is where the acuity score of the patient is six points. At this level, the patient requires