Current and future occupational therapists should have an understanding of the Medicare A PPS system and be aware of annual PPS rule changes if working in a skilled nursing facility or related inpatient setting. We should also be informed about policy and payment issues in order to advocate for quality of care over quantity of care in the
An Advance Directive appoints a surrogate decision maker also known as the durable power of attorney for health care agent, to make medical decision on a person’s behalf (Nabili & Shiel Jr., 2015). Similarly, some states recognize orally spoken advance directives as legal. Advance directives primarily consist of three types a living will, durable power of attorney, and Do-Not-Resuscitate Order. “A living will is a document that specifies the kinds of medical treatment a patient desires and can be very specific or very general” (Alfonso, 2009, p. 43). This document only becomes effective when it reaches the hands of the health care team caring for the patient (Alfonso, 2009, p. 43).
Quality Topic The Pay-for-Performance (P4P) Payment Model Quality Topic Description Description: The P4P is a payment model, which offers financial incentives to health care providers for meeting specific performances measures. Medical care providers receive Medicare reimbursements that reflect the provider’s performance on specific metrics, which are based on adherence to expected health care processes, patient satisfaction survey (PSS) scores, or patient quality outcomes (Nix, 2013). Miller, et al. (2017) referred to it as a “modified FFS (fee-for-service)” method. Evidently, this model acts as a payment template for many of Medicare’s programs.
The Health Care Affordable Act is a health care reform policy that guarantees all citizens the right to health care. According to the American Nurses Association website, “the American Nurses Association has been advocating for health care reforms that would guarantee access to high-quality health care for all. With the passage of the Patient Protection and Affordable Care Act (PPACA), millions of people have greater protection against losing or being denied health insurance coverage, and better access to primary and preventive services. ANA recognizes the debate of health care is not over, and remains committed to educating the nursing public about how the changing system impacts our lives and our profession” (American Nurses Association, 2016, P.1). The Health Affordable Act has had a major impact on my practice, in relations to, providing holistic care to the community that seeks health care.
Before conducting this research I hypothesized that physicians’ experiences could help improve health policy and health law. My hypothesis was based on the fact that physicians have first-hand experience with what is going on in the healthcare system and are the ones that have to carry out health laws and policies. So, by listening to the experiences of physicians, policymakers could gain insight on what is working, not working and what needs to be improved within the healthcare system. The question that this study focused on was what is the hospitalist experience with New York’s Family Health Care Decisions Act (2010) at the University of Rochester Medical Center? In regard to this Act I wanted to see how using hospitalists’ experiences could be used to improve the Act.
Many states are experimenting with different models of integrated care to develop the best-case collaboration for patients and healthcare workers. In order to reduce the complications of the current health care system the integrated care offers methods of reducing long-term health cost and create better healthcare outcomes. For example, allowing shared patient medical records will increase efficiency and improve physicians understanding of their visiting patient. Having the full medical access for patients allows health care providers to make informed decisions on their patients overall care. This collaboration allows providers to work together in combination therapy more seamlessly and transparent to have better outcomes.
Most hospitals today send out a patient satisfaction survey so that the patients can reflect on their past visit and be transparent about whether they feel they were given quality care. The patient needs to know that without a doubt, that they will be given the best quality care. If a medication error accidentally takes place, it should be identified, acknowledged and there must be a corrective action
For example, the implementation of the Patient Protection and Affordable Care Act is two that are significant however, not the only two policy issues that have raised national attention. A question of should the federal and state governments have control of healthcare policy or the question of the policies generally supported by both parties? Healthcare reform was mainly put in place to ban the insurers’ from discrimination against pre-existing conditions, limits on age discrimination, and the elimination of lifetime caps. The health care system in the United States consists of a network of physicians, patients, hospitals, insurers, employers, regulators, and stakeholders. With a significant change that can impact one component can reshape the entire system.
The Healthcare Effectiveness Data and Information Set (HEDIS) and The Joint Commission grew out of a movement, which recognized the need to identify and measure quality health care in the United States. The origins of HEDIS and the Joint Commission may be traced to the establishment of “a minimum standards for hospital care” adopted by the American College of Surgeons as a part of the Hospitalization Standardization Program. The ACS directly linked quality medical care with a quality patient record. The concept of quality measurement came to light when statistician Walter A. Shewhart identifies good processes equal a good product. He further demonstrated a method of measuring the processes by collecting data to be analyzed and measured.
The new health care reform will help reestablish the nursing concepts such as patient-centered care, integrated plan of care, and overall health and wellness to help aid in the quality of care the patient will receive. The new health care reform will focus on the individual before they become overtly ill, shifting away from its past procedure-based, fee-for-service patient care modalities, and into a preventative based health care approach. The new models of public health care will include new development of community based health centers (school, work and home based) with many more nurses and nurse practitioners serving as the primary care providers (Hokanson,2015). It is true that nurses have not been able to be collectively involved in transforming healthcare, but because of the critical role the registered nurse plays in part of the quality of care a patient receives, nurses will now be able to lead the transformation of health care. Hopefully through the application of improved quality of care with the Patient Protection and Affordable Care Act (ACA), the profession of nursing will continue to rise and the need for continuing nursing education will also