In order for a hospital to be eligible for reimbursement through Medicare, they have to show that they are compliant by way of the Conditions of Participation. One way to show this is by getting an accreditation through The Joint Commission who meets the Medicare Condition of Participation standards. (La Tour, 2013).
Clinical Quality Medical professional should select quality measures for reporting such as commonly treated conditions, the types of care that are frequently delivered, the settings in which care is given, quality improvement goals and other quality reporting options that are available or being considered. A couple of options available are Physician Quality Reporting System and Value Based Purchasing. Both…show more content… Comprehensive Primary Care Initiative will help the patients with more serious or chronic conditions, follow care plans personalized for their needs. (CMS,2014).
Role of Health Informatics Professional In the hospital laboratory, test codes change every year. Lab techs have to pay close attention to these test codes to ensure that the proper test ordered by the physician is performed accurately and that the correct fee will be reimbursed by Medicare.
Impact on Workforce I feel that there will be a high demand for Information Specialists in the near future due to the ever changing demands of the healthcare system. With all the proposed changes to come in Medicare as well, this just supports my theory in the demands to come for the workforce as well as the increase in education that will also be needed.
La Tour, Maki, and Oachs. (2013). Health Information Management: Concepts, Principles and Practice (4th edition). Chicago: AHIMA Press.
CMS. (2013). Physician Quality Reporting System (PQRS) Overview. Retrieved May 12, 2014 from http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment- Instruments/PQRS/Downloads/PQRS_OverviewFactSheet_2013_08_06.pdf
CMS. (May 8, 2014). Hospital Value-Based Purchasing. Retrieved May 12, 2014 from http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-