Medicare Reauthorization Act

The Improving Medicare Post-Acute Care Transformation Act (IMPACT) standardizes data collection and data sharing among post-acute providers. The IMPACT Act is part of the Centers for Medicare and Medicaid services (CMS) effort on basing reimbursement on quality as it moves from voluntary reporting of quality measures to mandatory reporting, basing reimbursement on the data reported. Presently, post-acute providers are paid on a fee-for-service basis but with the IMPACT act, bundle payment will replace the fee-for-service. The bundle or value based payment pays for outcomes and not for the volume of services. The Act gives post-acute providers an incentive to work on

What is HEDIS? This abbreviation stands for the Healthcare Effectiveness Data and Information Set. This information set has morphed in its usefulness since 1991, where it was first termed the “HMO Employer Data and Information Set” (AHRQ, 2010). Since its inception, this information has been used by a majority of the country’s health care plans to evaluate performance. Today, the data sets allow for evaluation and more fluid comparison of certain areas of care and service. Furthermore, HEDIS comprises eighty-one measures that spans over five domains of care. Due to this amount of information gathered, stakeholders are given the opportunity to compare different plans in similar terms. In addition, the healthcare plans have the availability to view their own rankings to make necessary adjustments. The data sets are also examined to assess which plan is best for employers and employees based on specific needs. This data is also utilized when seeking accreditation and is now a powerful reimbursement tool. The HEDIS results are accessible for stakeholders via Quality Compass, which is a web-based tool that allows one to view and compare benchmark information (HEDIS, 2015).

The remedy is the Medicare Access and CHIP Reauthorization Act of 2015 (Title I- SGR repeal and Medicare provider payment modernization) that trumps the Sustainable Growth Rate (Medicare’s action which reigned in doctors’ costs by an annual budget target), cuts Medicare spending, and includes the CHIP program mentioned above (Medicare Access and CHIP Reauthorization Act of 2015, 2015).

With enactment of the Medicare Modernization Act (MMA) in 2003, Medicare began moving toward value-based payments, and the introduction of Affordable Care Act (ACA) in 2010 meant that Medicare accelerated its use of value-based payments as a means of improving outcomes and managing overall costs (Wofford, 2015).

The Medicare Access and CHIP Reauthorization Act (MACRA) was passed in 2015 to support and change the way to pay and evaluated the healthcare in the United states (NHRI, 2017). This law mainly helps to pay the health care providers for the Medicare beneficiaries. Similarly, this law also provides the way of new funding for technical assistance, measure development, data sharing and establish a new federal advisory group that mainly help the healthcare providers for their health care service.

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

On December 8, 2003, President Bush signed into law the Medicare Prescription Drug Improvement and Modernization Act of 2003 (Pub. L. 108-173).  This landmark legislation provides seniors and individuals with disabilities with a prescription drug benefit, more choices, and better benefits under Medicare. It produced the largest overhaul of Medicare in the public health program's 38-year history. The MMA was signed by President George W. Bush on December 8, 2003, after passing in Congress by a close margin. One month later, the ten-year cost estimate was boosted to $534 billion, up more than $100 billion over the figure presented by the Bush administration

Quality Improvement (QI) is an organizational approach leading to the quality of patient care and patient services through use of specific guidelines, principles, and methods to ensure quality of care for every patient and health care facility throughout the world. Quality outcomes focus on the principles of quality management. These measurements investigate the quality of care, patient outcomes and consumer needs, through being part of the participant group. This quality improvement discussion will review the foundational frameworks of QI and explanation of each framework in detail. Included in this QI report will be

Ransom, E. R., Joshi, M. S., Nash, D. B., & Ransom, S. B. (Eds.). (2008). The healthcare quality

The Performance measurement strategies that continue to support and participation in the Hospital quality allowance.

The Medicare Access and CHIP Reauthorization Act (MACRA) was initi-ated by the U.S. Department of Health and Human Services to bring about big changes in quality of care by altering payment methods of doctors. MACRA was signed into law in April 2015 by former President Obama. The Medicare Access and CHIP Reauthorization Act (MACRA) is bipartisan legislation that was passed quietly by Congress without controversy. MACRA significantly alters how the government pays physicians and doctors who treat Medicare patients. It is transforming the way Medicare pays doctors and hospitals for their services by moving away from the traditional fee-for-service method and towards a new payment method that is based on how successful treatments are for

Medicare may not be perfect but until this program is changed it is what we have currently. Medicare has gone through changes since its inception in 1965. The most significant legislative change to Medicare--called the Medicare Modernization Act or MMA--was signed into law President George W. Bush, on December 8, 2003 (CMS, 2013). In a country with a complex healthcare system, a healthcare system that is a hot political stand for every presidential candidate and for each side to have valid arguments for and against is to be expected. But to say that Medicare is heading for disaster can be a stretch. Baby boomers who are entering Medicare eligibility age should not fret; there will be doctors there to service them and Medicare to pay those doctors.

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 their prescription drugs because many have the problem of not being able to afford them on their own or have a lack of drug coverage with their existing plan. Low income seniors and those with limited resources will receive further assistance paying for medication. The second problem addressed by the MMA is that all seniors are receiving a standard Medicare and are not given choices of alternatives to better fit their needs. They will

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.

Examining planning for and effectively measuring the health care quality indicators make healthcare quality more transparent and provide information for quality improvement programs and initiatives in the healthcare system.