ecp

Full-risk models, not shared savings, let health systems deliver what patients really need Better health usually isn't the result of higher-quality health care. Factors outside the current health care system, social determinants like income, education, employment, food security, housing, and social inclusion, generally make a bigger difference especially in disadvantaged communities. We need to rethink how health care organisations can help their patients stay healthy and out of the hospital by addressing these essential factors. What's needed is a full-risk model, one that holds provider organisations fully accountable for the health outcomes of their patients. In this model, practices are paid a fee for each patient and then cover all the costs of caring for that patient, whether it's an emergency department visit, a hospitalisation, a surgery, a medication, or a stay in a skilled nursing facility. Only with this degree of accountability can provider organisations be fully aligned with the interests of their patients and invest in what they truly need. A full-risk model is daunting for most organisations. Alternatives have emerged to pursue value-based care without taking that plunge, though my colleagues and I believe that full risk is the most direct path to achieving high-quality care at a low cost while also creating incentives to invest in the services that patients need. Shared savings: the middle ground isn't enough The shared-savings model for health care is, at first glance, an appealing financial choice that lets providers progress towards value-based care. In this model, a payer gives a provider organisation a fixed budget to care for a group of patients. If the cost of the care provided comes in under budget, the provider shares the savings with the payer. There is, however, no penalty for failing to generate savings. Without this disincentive, a provider organisation faces no real pressure to innovate. Shared-savings models are often considered a good first step towards value-based care, as they appear to be the less-risky option for providers: There's a chance to win without risk of loss. But it isn't enough. While well-intentioned, shared-savings models have not consistently delivered lower costs. Results from the most common shared savings model for accountable care organisations, the Medicare Shared Savings Program (MSSP), are mixed at best. In its first year, accountable care organisations participating in MSSP experienced 1.4 percent savings the next cohort experienced no significant savings. With so much promise, why have the results of shared-savings models been lackluster? It's simple: In a shared-savings model, providers who are able to lower the cost of care create savings they must then share with the payer. That means the provider makes the full investment and does all the work, but doesn't get the full benefit. While a shared-savings model may feel less risky, it also reduces the incentive for innovation and investment in patient care. Consider a hypothetical program that provides low-income patients with subsidised transportation to their primary care appointments. This service could prevent waste by improving access and reducing the number of missed appointments, which in turn would decrease the number of costly hospitalisations. If this program reduced costs, under a shared-savings model the provider would have to turn over some of the savings to its payer partner. Such sharing, however, could mean that the return doesn't cover the payer's investment in the program. So while the program helps patients and saves money, the financial arrangement may prevent the provider from building this obviously advantageous program. A full-risk organisation, in contrast, has a strong incentive to invest in patient transportation

Test Plan Info

In a couple of months, before the targeted launch of Facebook Libra in 2020, it is expected that all software testing will have been carried out. The technical lead in charge of the project is presenting a test plan for the review and approval of the project steering committee. Preliminary testing will include testing of networks and interfaces with multiple platforms including coinbase, PayPal, VISA and MasterCard. The assumption that follows the testing is the same as with the software development approach. And in a steering meeting the technical lead mentioned the following points;

Some of the risks we face are resourcing, schedule, and scope:

• We will be using the software quality engineering team in the US office for the unit testing, both functional and non-functional, while the UK team will perform integration testing, and Geneva will coordinate the Libra association acceptance testing starting February 2020.
• The programming language used is Move, and some unique features to be tested are server farms, protocols, data structures, transactions, digital wallet, and validator functionality. Out of the scope of this testing are consensus development, server farms connectivity, API generations, data centers, and database modifications.
• We are changing from IBM solutions to Atlassian software products for defect tracking and reporting.
• We have developed the following test environments: dev, testing, training, mock, final prep, and prod.
• We are using hardware specially designed by Antminer and Ebang for running functional and performance testing.
• We have the appropriate government and regulatory approval to use financial data from some of our partners: Paypal and MasterCard.
• Testing technology include the Lasgidi testing toolbox, hyperledger composer, and Libra Node Tester 2.0.
• The testing must sufficiently pass quality standards, regulatory compliance, and users' requirements to be considered successful.

1. question- Introduction

[Provide brief summary of the product that is being tested. Identify all applicable testing that applies to this test plan and product of the project - unit testing, integration testing, regression testing, smoke testing, sanity testing, beta testing, and/or user acceptance testing. Please include audience, purpose and context of the testing exercise.]

2 question-Assumptions and Constraints

[Identify a test approach - choosing a software development methodology. Describe if the testing approach/strategy is based upon any assumptions or dependencies and limited to constraints that have a significant impact on the testing of the system, application, or situation.]

3 question Feature Testing

[Identify features and components that are to be tested and those that are not tested and the reasons for them.]

3.1 Features to be tested

[List and describe application or system functions/features that are to be tested.]

3.2 Features not tested

[Describe components and features that out of scope of this test plan.]

4 question-. Defect Tracking and Reporting

[How will defects be captured, tracked, triaged and reported?]

5 question-. Pass Criteria

[What is the pass criteria for the testing?]

6 question-. Test Environment

[Provide details and a graphical presentation (if available) of the environmental components required to test the system to include: hardware, software, communications, and any other resources used to configure the test environment(s), as well as any security considerations.]

6.1 Hardware

[Identify by name, number, and version, as applicable, all computer hardware, interfacing equipment, communications equipment, peripherals, etc. that will be required.]

6.2 Software

[Identify by name, number, and version, as applicable, all software items (e.g., operating systems, compilers, communications software, related applications software, databases, input files, code auditors, dynamic path analyzers, test drivers, pre-processors, test data generators, test control software, other special test software, post-processors, etc.).]

6.3 Test Data

[If applicable, list test data here to be used in the test.]

6.4 Testing Tools

[List any testing tools that this project will utilize.]