Blue Cross Blue Shield Of Georgia

The risk management program in any business, especially in a health care organization is an integral part of its day to day operation. The purpose of the risk management department is summed up by Kavaler & Alexander (2014), “…a program designed to reduce the incidence of preventable accidents and injuries to minimize the financial loss to the institution should any accident or injury occur” (p. 5). Protecting employees, patients, vendors and visitors is an ongoing process and one that needs to be updated when the healthcare organization has deemed necessary. This paper will demonstrate the importance of presenting the risk management program to new employees, compliance with the standards set forth by the American Society of Healthcare Risk Management (ASHRM), propose recommendations or changes needed to further improve the program, as well as examine the administrative process of managing a risk program.

With nearly all health care institutions participating in some form of quality improvement (QI) activities (Walston, Burns and Kimberly 2000; Manuel 2008; Gowen Iii, Stock and McFadden 2008; Chassin 2013), the lack of substantial improvement in quality is disheartening (Glasgow, Scott-Caziewell and Kaboli 2010; Chassin 2013). Unless substantial changes are made to the way in which quality improvement is conducted with an effort to seriously address the widespread overuse of health services, desired progress will not be achieved (Chassin 2013). Thus, healthcare providers need to study, develop, implement, and sustain process management systems which must investigate a clear identified problem and improve patient and worker safety while enhancing

Quality management is essential to the success of the quality improvement of the health care industry. “Management uses management and planning tools to organize the decision making process and create a hierarchy when faced with competing priorities “( Ransom, et al., 2008). Quality measures should have these goals: effective, safe, efficient, patient-centered, equitable, and timely care (Quality Measures, Center for Medicare & Medicaid Services, 2011).

The Joint Commission has instituted a number of goals nationally; the aim is to improve patient’s safety. The goals selected look at areas that are of concern in the healthcare industry particularly how it affect patients safety and make recommendations how to reduce if not eradicated these. The Joint Commission is the governing body that accredited hospitals and other health care organizations. The two hospitals that this paper will be comparing, using the goals and criteria recommended by the Joint commission, is Holy Cross Hospital located at 1500 Forest Glen Road, Silver Spring, MD and Shady Grove Hospital situated at, 9901 Medical Center Drive, Rockville, MD.

This quality improvement discussion will review the purpose of quality management in health care industry and why it is needed. Included in this QI report will be an explanation of the

Anthem Blue Cross and Blue Shield focus on helping members get healthy and stay healthy. They serve you in the best way they can, each year they look closely at the medical care and programs that is best for you. They measure their quality and safety. The process of figuring out how to improve your care is called Quality Improvement programs. Anthem cares about the member’s satisfaction with their medical care, delivery of care, their doctors, health plan and service they deliver. https:\www.anthem.com

Risk Management and Quality Improvement/ Together At Last-Part 2 By: Darr, K, Hospital Topics; 1999 Spring Vol. 77, Issue 2

Quality management departments collect and analyze data to ensure quality care that is safe and effective for patients. Positive outcomes are crucial for success, and are measured objectively to monitor, and revise improvement programs implemented. Regulatory and accreditation agencies set the standards for patient safety defining quality indicators that health care organizations measure, and evaluate to sustain accreditation with compliance. Data proves compliance with best practices and positive outcomes, increasing reimbursement and the number of individuals who will come to the organization for care. Administration leadership has found that

Blue cross was founded in 1929 by Justin Ford Kimball, a vice president of Baylor University health care facility in Dallas who introduced the plan to provide hospital care services. Justin Kimball first plan was to guarantee teachers 21 days of hospital care for $6 dollars a year. The plan became popular it was extended to other groups nationally, and other employees started using it throughout the United States. In 1939 blue shield was founded in California by a group of employers providing medical care to their employees by providing a monthly fee, which help pay for physician services. Later in 1980s both company merged, and became successful since providing the best health care service at a low cost nationwide.

I took away valuable insights on how the inventive program works and function for the company Arkansas Blue Cross Blue Shield. On that agree on the fact of ABCBS wanting to stay ahead in the insurance field with incentives. On the other hand, other company's may not be able to afford, if not some of the incentives offered by BCBS, such as tuition reimbursement, Club Blue a free gyms offered at multiple ABCBS locations to encourage exercise and convenient employee health clinic as ABCBS does.

Blue Cross and Blue Shield headquarters is located in Chicago, Illinois. The Blue Cross Blue Shield Association (BCBSA) is a federation of 36 separate United States health insurance organizations and companies, providing health insurance to more than 106 million Americans today. Blue Cross was founded in 1929, and became the Blue Cross Association in 1960, while Blue Shield emerged in 1939 and the Blue Shield Association was created in 1948. The two organizations merged in 1982. Blue Cross and Blue Shield developed separately, with

Healthcare risk management ( HRM) began in The late 1970s, when hospitals are facing a malpractice crisis (Kavaler & Alexander, 2014). According to Kavaler and Alexander (2014), it is estimated more than 140,000 Americans die from medical errors and the cost ranges between $17 billion and $29 billion each year in the United States (Kavaler & Alexander, 2014). In this essay, the student will explain a healthcare risk management program, evaluate the program for compliance with the American Society for Healthcare Risk Management (ASHRM), and Examine the administrative process of management the risk program.

Making a quality organization structure is an epic test for a few affiliations. A quality organization system is a structure to develop plans and objectives to direct and control a relationship concerning quality (Schroeder , 2000). The essential need is to ensure that top organization sees the prerequisite for a quality organization structure and is made plans to reinforce its creation, execution and backing. This may be a tremendous starting stride if organization is satisfied by the same old thing. They may not see any preferred standpoint to having systematized frameworks which, even they ought to consent to. They may not understand the upsides of therapeutic action, organization reviews,

From the beginning of time man has sought out ways to improve what he does. Man has advanced from simple tools made of stone and sticks to being able to transplant human organs, cure diseases, and even place a man on the moon. How did man accompish this? Through quality improvements, best practices and the desire to make things better. I will be discussing quality improvement programs with a focus on my organizations goals, objectives, structure, selection and management of these projects. I will discuss the methodology, communication, and evaluation of the projects, as well as, examples of these programs in my facility.

Quality is something that every health care agency strives to achieve. The Institute of Medicine (IOM) suggests that health care organizations develop a culture of safety such that an organization's care processes and workforce are focused on improving the reliability and safety of care for patients (Groves, Meisenbach, & Scott-Cawiezell, 2011). In order to address an issue related to health care quality, it is important to look at the frameworks that will analyze an organization and identify opportunities to improve performance. The purpose of this paper is to provide a description of an organization and an analysis of the following: mission, vision and values, strategic plan, goals,