Fragmented Health Care

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Healthcare is a business and a large one at that. Hospital spending alone is expected to reach one trillion dollars when final numbers are released for 2015 (Centers for Medicare and Medicaid, 2016). With this type of spending, hospitals are uniquely charged with improving the health of the residents in their communities. At no time, should the health care provider cause harm. However, harm is what has occurred in health care. Due to a fragmented health care system, health care is in turmoil (Kohn, Corrigan, & Donaldson, 1999). It was estimated in the 1999 book, To Err is Human that anywhere from 44,000 to 98,000 people die each year in hospitals due to medical errors (Kohn, Corrigan, & Donaldson, 1999). Initiatives were put into place to combat…show more content…
One common administrative agency in health care is the Centers for Medicare and Medicaid Services (CMS). The leader of CMS is appointed by the President to serve as the agency’s head. CMS administers programs such as Medicare and Medicaid and creates the rules that must be followed to bill and subsequently collect Medicare and Medicaid money. Many of the patient care concerns brought forth by CMS are settled without any further action. However, health care providers can also bring a legal action against the agency. In the case of Cooper University Hospital v. Sebelius (2009), the health care provider disagreed with the limitation CMS had put on the number of low-income patients the disproportionate share hospital claimed on their cost report. The hospital involved in this case felt the number of charity care program patients should be included in the calculation. Ultimately the decision was that charity care program patient days should not be included in the calculation for the disproportionate share hospital and the case was decided in favor of CMS (Cooper v. Sebelius, 2009). This administrative law case shows the reach of the administrative agency into the inner workings of a…show more content…
A tort is “a violation of another person’s rights or a civil wrongdoing that does not arise out of a contract or statute” (Kubasek, Browne, Herron, Dhooge, & Barkacs, 2016, p. 126). Tort law was established as a way to compensate those who have been injured and helps to establish order by encouraging the use of the legal system to right any wrongs that have occurred. The damages awarded in tort law cases can be rather large, therefore a health care business needs to mitigate the risks identified with providing patient care. Robust training and retraining programs, standard care protocols, and appropriate insurance coverage, can ensure the health care provider is prepared when things go wrong. It is important for health care providers to determine appropriate standards of care and build policies around them to ensure patients are well cared for and
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