Full Answer Section

This executive summary will outline the organization’s financial viability given the challenges facing health organizations, particularly those operating in rural communities.

Different Types of Healthcare Payment Models

There are a number of different healthcare payment models that Metropolitan Memorial could utilize. Some of the most common types of payment models include:

• Fee-for-service: This is the traditional payment model, in which providers are paid for each individual service they provide.
• Capitation: Under this model, providers receive a fixed payment per patient, regardless of the number of services the patient receives.
• Value-based payment: This model rewards providers for delivering high-quality, efficient care.

Metropolitan Memorial should consider transitioning to value-based payment models in order to improve its financial viability. Value-based payment models align with the organization’s mission to provide high-quality, affordable healthcare, and they can help to reduce costs by incentivizing providers to deliver more efficient care.

The Triple AIM

The Triple AIM is a framework for improving the quality, affordability, and access to healthcare. The three goals of the Triple AIM are:

• Improving the experience of care
• Improving the health of populations
• Reducing per capita costs of health care

Metropolitan Memorial can achieve the goals of the Triple AIM by:

• Focusing on preventive care and wellness programs
• Investing in technology to improve care coordination and efficiency
• Collaborating with other healthcare providers in the community

By focusing on the Triple AIM, Metropolitan Memorial can improve the quality and affordability of its care, which will make it more attractive to patients and payers in rural communities.

Payer Mix

The payer mix is the percentage of revenue that a hospital receives from different types of payers, such as Medicare, Medicaid, and commercial insurers. The payer mix can have a significant impact on hospital revenue, as different payers reimburse hospitals at different rates.

Metropolitan Memorial should carefully consider its payer mix when expanding into rural communities. Rural communities tend to have a higher percentage of Medicare and Medicaid patients, who are reimbursed at lower rates than commercial insurers. Metropolitan Memorial should develop strategies to mitigate the financial impact of a lower payer mix, such as investing in value-based payment models and partnering with local businesses and organizations to provide healthcare services.

Value-Based Healthcare Delivery

Value-based healthcare delivery is a model of healthcare that focuses on providing high-quality, efficient care at a lower cost. Value-based healthcare delivery can be achieved by:

• Investing in preventive care and wellness programs
• Reducing unnecessary tests and procedures
• Using technology to improve care coordination and efficiency

Metropolitan Memorial should adopt value-based healthcare delivery practices in order to improve its financial viability. Value-based healthcare delivery aligns with the organization’s mission to provide high-quality, affordable healthcare, and it can help to reduce costs by incentivizing providers to deliver more efficient care.

Conclusion

The expansion of Metropolitan Memorial’s services into underserved rural communities is a challenging undertaking. However, it is an important undertaking, as it will help to improve access to healthcare for underserved populations.

By utilizing value-based payment models, focusing on the Triple AIM, and adopting value-based healthcare delivery, Metropolitan Memorial can mitigate the financial risks associated with this expansion.

Additional Recommendations

In addition to the above recommendations, Metropolitan Memorial may also want to consider the following:

• Partnering with local businesses and organizations to provide healthcare services at their facilities. This can help to increase access to healthcare for rural residents and reduce the financial burden on Metropolitan Memorial.
• Offering telemedicine services to patients in rural areas. Telemedicine can help to reduce the need for rural residents to travel long distances to receive healthcare.
• Developing mobile health clinics to provide care to patients in remote areas. Mobile health clinics can provide healthcare services to rural residents who live in areas that are not well-served by traditional healthcare facilities.

By taking these steps, Metropolitan Memorial can expand its services into rural communities in a financially viable way.