Agency Evaluation : Care Matters Llc

The Recovery Audit Programs (RAC) is to identify any Medicare collection that is under any detection and collection of overpayments that are made on claims of health care services that are provided by Medicare beneficiaries, and to identify any payments that are provided so that CMS can take any actions that can prevent future improper payments in all 50 states. RAC programs is a successful program that utilizes the recovery Audit to identify ant Medicare overpayments and underpayments to health care provider to suppliers in selected states. The demonstration that has been ran between 2005 and 2008 has resulted in over $900 million in overpayments that has been returned to the Medicare Trust Fund and there has been $38 million in underpayments that has been returned to the health care providers. This has resulted in Congress to require the Secretary of the Department of health and Human Services to have a permanent and national Recovery Audit programs to help on overpayments that are associated with services for which payment are made under Medicare part A or B Which is the Social Security Act. For every Recovery Audit has a responsibly to identify any overpayments and underpayments that is within ¼ of the country.

Prepare a plan for all social care workers and helpers to follow. Your plan should include the following information.

This paper will discuss what the Accountable Care Organization is, why did Congress include it in their law, benefits and challenges for physicians and patients, and how does the ACO work for patients. We will also identify the quantitative methods in the ACO and reflect on the information provided.

Accountable care organizations (ACOs) are consist of providers who are jointly held accountable for achieving measured quality improvements and reductions in the rate of spending growth.

In the past few years the American health care system has changed in many ways. First there was the passage of the Affordable Care Act, which is a law that is giving Americans the opportunity to obtain health care. Under this new law, in 2011, the Department of Health and Human Services decided to create Accountable Care Organizations (ACO) to help doctors, hospitals and other providers better coordinate care (AthenaHealth.com). The first idea of an Accountable Care Organization was brought up in 2006 by Elliot Fisher, MD, and now there are over 400 in the United States (Healthcatalyst.com). An ACO’s primary job is to improve health care delivery, performance, and payment. This is done through physicians and

The accountable care organization I researched is called the Physician Organization of Michigan ACO (POM ACO). The POM ACO is a joint venture of the U-M Health System and physician groups around the state, with the aim of improving care for 81,000 Michiganders enrolled in traditional Medicare and slowing the growth of health care costs, according to the announcement by the U-M Health System (Daly, 2013). The group was launched on January 1, 2013 under the Medicare Shared Savings Program. 12 physician organizations from around Michigan came together to take part in a Medicare-sponsored program that strives to improve on the quality of care for traditional Medicare recipients, while also containing cost growth. In 2014, POM ACO expanded to include all the University of Michigan faculty physicians and thousands of other providers from the University of Michigan Health System. The POM ACO is now one of the largest accountable care organizations nationwide. More than 5,700 physicians and other providers are now involved in the POM ACO. Therefore, the POM ACO is organized as a physician-hospital organization. Hence, the patient has more flexibility in where and how their care is delivered. The patient can still use any doctor or hospital that accepts Medicare at any time.

Providence Home Care LLC is a home health care service institution that is located in Oklahoma City, Oklahoma. This home health care agency was established in 2002. Providence Home Care LLC offers home care and private duty services. Some of the home health services include wound care, hospital prevention protocol, skilled and psychiatric nursing, monitoring chronic illness, physical, occupational, and speech therapy, patient and caregiver education, and more. Providence Home Care LLC has been awarded for being a National Top 500 Agency. This home health care facility is also the winner of the Quality Excellence Award.

Good morning, there have been many speculations about Right Way being bought over by Always Right home care agency. Today I am pleased to announce both companies have reach an agreement and a merger will occur. Although, our assistant living has been proving great care for our seniors in the bay area for 40 years we hope to expand beyond the Tampa Bay area. There has been a growing need to provide more services to our aging population and it is important for our company to grow and expand to meet the needs of our seniors. Right Way vision and mission is to help improve quality of life for all we serve, offer cost effective services, and have unlimited accessibility to variety of services.

Like the bundled payment model, Accountable Care Organizations are rapidly becoming a common occurrence in the American health system. ACOs are saving hundreds of millions of dollars. Research has shown that the longer an ACO is established the better it will perform and the more savings it will generate . Last year, ACOs that were formed in 2013 saved $204 million while those started in 2016 saved $5 million . In total, all ACOs saved a combine amount of $652 million . These results also show that successful ACOs are improving care quality. “For all ACOs in their second year or more, they on average received 93.4 percent of the maximum possible score” . Examples of successful ACOs are the Palm Beach ACO and the Mercy ACO.

2. Preparation – The worker then meets with the family members and understands their problems and situations and then invites them to participate in it

ArdentMC is unclear if the actual intention of this interim CPARS is to evaluate both Task Order A – Program Management Support & Task Order 3 – Communications & Outreach. The “Project Title” & “Contractor Effort Description” as written by the Government’s evaluating official would seem to reference only Task Order A – Program Management support SOW and within this host of deliverables dwelt on only one deliverable. As a result, it would seem that any written comments from the Government’s evaluating official would need to be limited to just the “Project Title” and “Contractor Effort Description” as originally described (i.e. Task Order A – Program Management Office Support) and cover all the deliverable within the SOW.

Once contract services begin, agencies become primarily responsible for ensuring that the vendor is meeting contract obligations and performing any other necessary activities as agreed upon. An effective contract monitoring system alleviates risk and prevents any adverse effect on the agency. Therefore, it’s the responsibility of the agency in ensuring that contracted services are adequately delivered. The agency should have a program in place through its central office to conduct oversight and monitoring of the civil service or privatized health services program. A correctional administrator must have the expertise in his or her executive staff to judge the competency of the health staff, the adequacy of the health services being delivered

Dr. Robert Master, the founder of Commonwealth Care Alliance (CAA), had created the company with the vision to ‘bring high-quality and personalized care to people with complex medical and behavioral needs, resulting in improved health and better self-management of chronic illness, thereby reducing hospitalizations and institutionalizations.' Therefore, the main objective was to provide care outside the walls of hospitals and institutions to make it easier for the chronically ill and disabled to receive the attention they

Results-based accountability framework: There is not a results-based accountability framework. This is a significant deficiency to the program, although stated in the Falls Free 2015 National Action Plan, the plan is leveraged on past data and progress, and it is not clear how the goals and objectives are formulated or based off of. Evidence is not provided to show whether results-based accountability framework is drives future program growth.

This definition clearly shows that PA offers a chance to assess or judge various aspects of an employee’s work performance by checking back how they have performed in the past and then predicting and developing their future performance. However, it is difficult to be translated into a