Medicare Quality Initiatives Analysis

Performance HCS/451 Health Care Quality Management and Outcomes Analysis This paper will propose how TriCity Medical Center will monitor performance, achieve regulatory and accreditation compliance, and improve overall organizational performance. It will describe ways TCMC will communicate with leadership to ensure alignment of organizational goals and gain buy-in from staff to achieve compliance with the standards and requirements issued by regulatory and accreditation bodies. Also it will determine how compliance with the regulations and development of risk- and quality-management systems for the organization contributes to the organization’s overall performance-management system.

Quality Improvement Organizations (QIOs), work in partnership with the Centers for Medicare and Medicaid Services (CMS) to advocate for safe, efficient, and quality healthcare for Americans. Working at the community level, QIOs collaborate with providers and interact with beneficiaries to improve patient outcomes. Additionally, QIOs support new models

When establishing a health agency, there are specific requirements established by the government and professional agencies that we have to adhere to. In addition to state or county rules, there are federal rules and non-government standards that apply throughout the field, regardless of location. These regulations affect both your organization’s

Why Quality Management is Needed in the Health Care Industry 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).

CMS – Medicare/Medicaid The Medicare and Medicaid programs were signed into law on July 30, 1965 by president, Lyndon Baines Johnson. The Centers for Medicare & Medicaid Services (CMS) is an agency within the US Department of Health & Human Services in charge of administration of several key federal health care programs. CMS is responsible for health care programs such as, the Health Insurance Portability and Accountability Act (HIPAA), the Clinical Laboratory Improvement Amendments (CLIA), and the Children’s Health Program (CHIP) amongst other services.

Affordable Care Act requires that all skilled nursing care centers develop Quality Assurance and Performance Improvement programs. The statute requires the Centers for Medicare & Medicaid Services (CMS) to develop a prototype QAPI program, establish standards, and provide technical assistance to centers on the development of best practices in order to meet such standards.

¬¬Abstract The Medicare Modernization Act, or Medicare Prescription Drug Improvement and Modernization Act of 2003, was passed into law to amend and modernize the current Medicare system. There are a few problems that this law aims to solve or provide relief towards. First, it will allow seniors to save money on

to ensure small practice management concerns are addressed. • Centers for Medicare & Medicaid Services (CMS) works directly with PAHCOM to create and provide

Centres for Medicare and Medicaid Services (CMS) CMS is regulatory agency which works within the United States Department of Health and Human Services. It administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (SCHIP), and health insurance portability standards.

As the industry continues to move away from some of the Medicare programs that were created during the Obama presidency,  the Centers for Medicare & Medicaid Services (CMS) is also pulling away from specific value-based initiatives, such as mandatory bundled payments. The CMS officially canceled two of the models that

1. Hospital Compare is a free online source created by CMS and is available to everyone. It gathers information from over 4,000 Medicare-certified hospitals and rates the quality of care that patients received. This is an advantage to patients because they are able to compare hospitals and choose the best one. This site has also motivated those hospitals that are not providing a high quality of care and helped them see areas that need improvement.

This was evident by one manager who told me that since the adoption of their tele-ICU system, they had been able to implement many more quality-of-care initiatives in their ICUs -- and to update their quality-improving protocols much more frequently. This intertwining of the technology with the clinical quality improvement initiatives makes evaluating the effects of the technology more challenging. But having interviewed senior tele-ICU managers, and studied health system transformation and quality improvement, I believe that such multidimensional analyses and thinking are crucial for appreciating what is required for delivery system reform to improve both quality and cost-efficiency.

Quality measures are strategies that gauge, evaluate or compute health care processes, results, discernments, patient insight, and administrative structure. In addition, quality measures are frameworks that are connected with the capacity to deliver first-class health care and/or that are able to identify with one or more quality objectives for medicinal services. These objectives include: compelling, protected, effective, quiet focused, impartial, and opportune consideration. Quality measures can be used to measure quality improvement, public reporting, and pay-for-reporting programs specific for health care providers (CMS.gov, 2016). There are an assortment of quality measures in which health care organizations can use to determine the status of the care they are delivering. Many are appropriate, but few are chosen for this research paper. Among them are: National Health Care Surveys, Hospital IQR Programs, Scorecards, and Political, Power, and Perception/Data for Decision-making tools.

Health care systems are reporting and monitoring quality of care indicator data with increasing regularity.

-Examine at least three (3) examples of quality initiatives that could increase patient satisfaction and potentially reduce healthcare cost. Support your response with examples of the successful application your chosen quality initiatives.