The NCQA ACO program is meant to create an alignment of the healthcare plan with the state, employer, and even the federal purchasers need to form a leverage that will be used in the promoting of organizations to make a transformation for healthcare providers (Carver & Jesie, 2011). The best thing about the ACO accreditation is that it helps making a determination of whether the various organizations have the right infrastructure for accountability. The purchasers are more concerned with whether the organization is in a better position to serve. They are also in need of assurance that they will get quality care from the organizations. Through the process of NCQA accreditation, the purchaser gets the right information (Blazej,
Information Literacy and Professionalism Information literacy is a crucial part of every career and contributes to one's professionalism and skillset. Developing information literacy skills involve acquiring necessary information and applying it according to the situation at hand. Being information literate is especially important in the healthcare field due to the advancements in technology and research that may improve medicine. With these constant changes, healthcare professionals must learn to find relevant information that can be useful and efficient in diagnosis and treatment. Information Literacy as an Ethical Responsibility I agree that being information literate is an ethical responsibility in every profession, especially with the
Please respond to the following: "Marketing Management Tools" Based on your review of the Learnscape scenario titled “Learnscape 2: Patient Engagement”, analyze the benefits afforded to health care marketers that understand the importance of establishing core values that guide health care organizations in their strategic and tactical pursuits. Determine whether you believe the relationship between core values should stay the same over time or should change over time. Provide one (1) example of such a relationship between core values to support your rationale. Establishing of core values is very critical for any healthcare organization, because core values support the healthcare organization’s long term vision, core values help in shaping organizational
JHM’s Strategic Plan Executive Council certainly had these ideas in mind when creating their priorities, goals, and strategies to reach each. Johns Hopkins Medicine (2013) strategic thinking took into consideration health care reform, including an increased need for accountability, transparency and controlling costs, the necessity to maintain stability while creating new responsive structures and honoring their mission of patient care, research and education, all the while emphasizing quality and affordability to meet consumer expectations in a competition driven market. Stakeholders that have influenced this strategic effort consist of employees at all levels, even potential future employees, patients and consumer, payers including state and federal, and the community that they serve, or as a broader whole, humanity. “Success occurs with an organizational strategy that focuses on new processes and services that meet the healthcare and financial needs of the customer while disrupting the status quo” (McLaughlin and Militello, 2015, p.
Charfi Medical is implementing a compliance program to prevent fraud, waste, and abuse. This compliance plan has a mission of providing quality patient care. The compliance plan’s objectives are to provide a proactive program that ensures full compliance with all applicable policies, procedures, laws and regulations especially HIPAA. The HIPAA Privacy Rule creates a base of Federal protection for personal health information, cautiously established to avoid creating unnecessary barriers to the delivery of quality health care. Compliance plan objectives: Implementing a medical compliance plan limit our liability by reducing innocent billing mistakes and exposure to fraud and abuse allegations, which helps avoid governmental audits.
With the use of EHR comes the opportunity for patients to receive improved coordinated care from medical professions and easier access to their health data. The author identifies views about the problems of EHR and the legislation. Health care professionals understand and accept the obligations under the Privacy and Security, patient’s information can still be at breached if those involved in patient health do not make sure that their information is secured. There is an increased risk of privacy violations with EHR if used improperly. Even though there are legislations in place to protect patient’s information, data still can be easily accessed either intentionally or accidental by using improper security measures.
Your choice of providers may be limited to those within the network, or your out-of-pocket costs will be lower when you obtain services from providers within the network. A managed care plan is an arrangement with a selected network or group of organizations; it is evolved as a way to reduce the cost of health care and improve the quality of care using a variety of techniques. In other words, managed care is a technique to bring the health insurer, health care providers, medical facilities as well as the individual who wants to be insured just under one umbrella. Under fee for service plans this type of health plan, the health insurer is liable to pay the claimed bills of health care services provided to a policyholder. Similarities and differences FFS, you can go to see any physician you want, whenever you feel it is necessary.
1 posts Re:Topic 5 DQ 2 Continuous Quality Improvement (CQI) is a strategic approach to providing the best healthcare possible. It is a preventative strategy that uses constant innovation to improve work processes and systems by reducing time-consuming, low-value activities. Time that was once spent on rework and crisis management is now spent on planning, coordination and control. As a nurse manager, one of my duties is to map out a sustainable plan that is efficient and effective enough to help my organization face the issues of performance and quality of care (Ballard, 2010). By implementing CQI, I will form a team that can help me to identify problems and challenges towards achieving effective and result oriented healthcare.
According to a provision under the ACA, Medicare would be remunerating healthcare organizations from the savings acquired through care quality enhancement and cost reduction. It is mandatory for all the health care organization to be transformed into Accountable Care Organization to promote this shared savings program. This model also has a dominant contribution to a skillful patient treatment during the care course. Some affiliates of a particular accountable care organization provide health care same means to all the practitioners, hence the medical tests and appointments are conducted under that. If a patient pursuing second opinion or any specialist’s opinion rather than the insight of a primary care physician, he will be referred to the specialist within that organization in order to keep the patient from incurring additional
Therefore, the APN has a distinct set of skills that will ensure positive patient outcomes. Another contributor to quality care is the use of evidence-based practice (EBP). EBP is an approach to solving issues that integrate the best evidence from well-designed studies from a clinician?s expertise. These studies extrapolate the evidence from patient assessments, preferences, values, and practice data. The findings from these studies yield research that leads to higher quality of care, positive patient outcomes, increased quality of care, and decreased costs (Mazurek, Fineout-Overholt, Gallagher-Ford, & Kaplan, 2012).
Care Compassion Competence Communication Courage Commitment It is important that a health care professional has these attributes in order to work successfully in their professions. They must have full dedication for the care of their patients and true passion to improve the individual’s health. They must show understanding and empathy towards each person’s situation and always keep confidentiality. One of the most important attributes is the ability to have courage to speak up when needed. This means acting as an advocate for the patient.
Reporting how the data was collected in the report card would also be beneficial as it generates accountability and trust in the minds of the user, making it more probable that the patients actually use the report cards in choosing their healthcare professional. Providing guidelines, and educating consumers on the use of report cards could be the key factors in improving its overall usage. Further, in order to ensure equal healthcare access, authorities need to figure out a way to avoid situations where physicians choose patients based on the severity of their illness. Finally, tying quality outcomes to reimbursements is an effective way to ensure that healthcare providers stay on the path of continuous quality improvement. Altogether, report cards are a great way to educate healthcare consumers and generate better accountability among providers leading to higher quality of care, but we all, as consumers or providers need to perform our roles in order to make this a successful
3.” ("Interoperability," 2010) Interoperability will be important in this situation because with having two organizations that have just merged it will look at the discrepancies between the two organizations on a foundational, structural and sematic level which will ensure that all the information and data will be shared in the new system assisting in the medical providers being able to see the most up-to-date information on the patient population to make a smooth and easy transition of care. A4a. Standardized Nursing Terminology The importance of standardizing nursing terms is to have better communication in the medical community, which assists in having better patient care and with the standardization evidence-based data can be collected to help increase better patient outcomes. Standardization will assist in nurses following standards of care; increase the ability to see what the nurse has done for the patients, and assist in looking at the competency level of the nurses. 5.Two Federal Regulatory Requirements Two identified federal regulatory requirements that have been identified
In any given situation patients are depending on staff members to educate them and help them seek the right answers to their questions and concerns. A physician 's promise is to treat all patients the same regardless of their condition or finance state because patients and their loved ones are putting a lot of trust in them. If a patient has a patient directive on file, it must be followed out as the patient 's wishes and explained to the