Question
I have included the mini-case study (5 pages truly) as a PDF. I have also included an excel sheet where the tabs showing the work
I have included the mini-case study (5 pages truly) as a PDF. I have also included an excel sheet where the tabs showing the work I've done in answering the questions. I have entered all table/charts correctly. My specific questions in completing this assignment are: -Question 1A are my benchmarks within reason as highlighted in color orange? -Question 1B any additional comments to my reasoning as highlighted in orange? -Question 2 I'm not sure how to answer whatsoever! How am I supposed to compare metrics that I suggested as part of response to Question 1A? -Question 3A&B would you suggest any other reasoning other than what I have already entered? -Finally, Question 5. Are those three key learning points? Would you suggest any others? *Please disregard the questions at the end of the case study as the instructor has provided their own questions as written below:
1. a. Using the template given in Exhibit 30.1, add one additional overall benchmark and one
defect benchmark for each of the revenue cycle functions listed.
b. Describe each metric in the completed template and provide justification as to why these
benchmarks were chosen over the alternatives listed in Exhibit 30.2.
2. Compare the benchmark values in your completed template with the actual MRHS metric
values given in Exhibit 30.3. Discuss your results. Most important, suggest what actions might
be implemented to improve revenue cycle performance.
3. a. Complete the reimbursement amount template provided in the case for CPT 73722 (MRI of
the knee) and DRG 470 (major joint replacement). Discuss the fairness and efficiency of
the current fragmented reimbursement system to providers, insurers, patients, and society
(the ultimate bearers of healthcare costs).
b. Assume that MRHS?s payer mix is 46 percent Medicare, 34 percent commercial/managed
care, 16 percent Medicaid, and 4 percent self-payo insurance. Calculate the average
expected payment for each of the two procedures.
4. In a single paragraph, describe the revenue cycle and why good performance is so important to
providers.
5. In your opinion, what are three key learning points from this case?
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