Payment Differences
Discuss rationale as to why there are vast differences in payment for the same services (by CPT-treatment code) by various payer sources (e.g., private pay, grant, Medicare/Medicaid, traditional insurance like Blue Cross/Blue Shield, or managed care). How does this practice impact the profession and budgeting? Provide a rationale for your choice.
PLEASE MAKE IT 200 WORDS EACH, THEY NEED TO BE EQUAL IN WORDS. EXAMPLE: 250 FOR ONE, then 250 FOR THE SECOND TOPIC. ONLY USE THE REFERENCE BELOW AND DO NOT COMBINE BOTH TOPIC, THEY NEED TO BE SEPARATE. IF YOU DO NOT FOLLOW DIRECTION, I WILL TAKE SOMETHING OFF.
Justifying Budget Loss
Not every operating budget must show a profit. For example, there are many examples of successful mental health and other health-related programs that are referred to as “lost leader” programs because they show a loss. This is common with grant-funded programs or benevolent foundation funding. Discuss how you would continue to justify a budget loss to a board of directors or grant funding agencies. What negotiation or conflict resolution strategy would you recommend if the board or agency does not accept the initial justification?
Readings
1.Textbook:
Dropkin, M., Halpin, J., & LaTouche, B. (2007). The budget-building book for nonprofits (2nd ed.). Jossey-Bass.
Chapter 14: Major Components of Operating Budgets
2. Article:
Chevarley, F., Owens, P.L., Zodet, M.W., Simpson, L., et al. (2006). Health care for children and youth in the United States: Annual report on patterns of coverage,utilization, quality, and expenditures by a county level of urban influence. Ambulatory Pediatrics, 6(5), 241-64.
3. Videos
McCarthy, J., [goldstarjimmccarthy]. (2010, September 1). Difference Between Fixed and Variable Costs – Quick Draw with Jim McCarthy, Goldstar CEO [Video File]. Retrieved from https://youtu.be/wBBfA9q8FSQ (Links to an external site.)
BPMSG, [BPMSG]. (2010, February 23). 06 Operating Expenses Fixed and Variable (Business Performance Management) [Video File]. Retrieved from https://youtu.be/Xc6F5rMCM40 (Links to an external site.)
