DISCUSSION BOARD 3 (IN 300 WORDS) (AIU journal articles) Although preventative services such as...

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DISCUSSION BOARD 3 (IN 300 WORDS) (AIU journal articles) Although preventative services such as routine well-care visits and immunizations have often shown to be beneficial in terms of preventing...

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DISCUSSION BOARD 3 (IN 300 WORDS) (AIU journal articles)

Although preventative services such as routine well-care visits and immunizations have often shown to be beneficial in terms of preventing future, more expensive, health care encounters, not all insurance plans offer reimbursement for such things. In addition, health care policies have only recently begun to recognize the "worth" of funding prevention-related services

Thinking about this from both a provider's and a payer's perspectives, answer the following questions:

What are the advantages and disadvantages of using the gatekeeper system in terms of progressing through the levels of care? Provide an example of each perspective.
What are at least 2 advantages and XXXXXXXXXXdisadvantages for each group? Provide a rationale for your choices.

DISCUSSION BOARD 4 (IN 300 WORDS) (AIU journal articles)

In an HMO, the primary care physician acts as the "gatekeeper" to all higher levels of care that the patient may need. In theory, this means that the physician decides what is best for the patient and coordinates his or her care, while at the same times working to control costs and trying to ensure the delivery of care in the most efficient manner possible.

Thinking about this from both a provider's and a payer's perspectives, answer the following questions:

What are the advantages and disadvantages of using the gatekeeper system in terms of progressing through the levels of care? Provide an example of each perspective.
What are at least 2 advantages and 2 disadvantages for each group? Provide a rationale for your choices.

Answered Same Day Apr 06, 2021

Abhinaba · Accepted Answer

Running Head: DISCUSSION BOARD RESPONSES			            	1
DISCUSSION BOARD RESPONSES						          	2
	
RESPONSES TO DISCUSSION BOARD
BOARD 3
The primary physician is part of the hospital administration that not only is responsible for providing care to the patient, but also is aware of all the costs and the benefits that can be retained by both the third party payers and the patients themselves. In most cases, primary physicians are given the task of leading care-providing taskforces in their respective organisations or regulatory bodies, in context of their knowledge in the field of care services and experience, gathered over years. The profound knowledge of the primary physicians makes them capable of managing taskforces better, especially developing safe and healthy practices, improving the quality of the care services altogether. 
The experience of working in care service providing in public or private sector, gives primary physicians, ample knowledge about the cost and benefits management in favor of care-users and third party payers. The primary physicians also have the ability to decide, what areas of their respective care systems, need improvements and the areas, where compromises can be made to safeguard the interest of the third party payers. In place of the primary physicians any other executive staff would only be able to make strategic decisions, lacking in care-facility assessment, thereby, justifying the responsibilities imposed on primary physicians. Therefore, this physician will always try to control the costs incurred by the payers to a bare minimum in the most efficient method possible. Having a low medical expense means that both the patients and the third party payers will be benefitted from such care practice. The awareness about using prevention related services are increasing.  A family doctor should be able to consult quickly a specialist to confirm or eliminate clinical concerns, and a specialist should be able to pass detailed instructions to the doctor for potential follow-ups (Greenfield, Foley & Majeed, 2016).

DISCUSSION BOARD 3 (IN 300 WORDS) (AIU journal articles) Although preventative services such as routine well-care visits and immunizations have often shown to be beneficial in terms of preventing...

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