Most Significant Issues Facing Health Care Organizations Essay examples

41 million Americans did not have health insurance in 2001. In 2004, the number rose to 45 million. And in 2005, 47 million people were living without health care. On the other hand, 84% of Americans had health care in 2005 according to a census. So what is wrong with America's health care?

In response to the “Patient Protection and Affordable Care Act (ACA) amended by the Health Care and Education Reconciliation Act (Reconciliation Act), collectively referred to as healthcare reform” (); Wishard-Eskenazi Health of Indianapolis, Indiana has begun to make milestone changes to meet the requirements of the healthcare reform. Being a leader in today’s technology which began thirty years ago with development of one of the nation’s first electronic medical record and continues to excel in the healthcare informatics technology today continues to use this technology in quality improvement initiatives, support for future technology research and improving the quality care of the patient.

Although the EHR is still in a transitional state, this major shift that electronic medical records are taking is bringing many concerns to the table. Two concerns at the top of the list are privacy and standardization issues. In 1996, U.S. Congress enacted a non-for-profit organization called Health Insurance Portability and Accountability Act (HIPAA). This law establishes national standards for privacy and security of health information. HIPAA deals with information standards, data integrity, confidentiality, accessing and handling your medical information. They also were designed to guarantee transferred information be protected from one facility to the next (Meridan, 2007). But even with the HIPAA privacy rules, they too have their shortcomings. HIPAA can’t fully safeguard the limitations of who’s accessible to your information. A short stay at your local

There are a number of free online resources to help providers who only need to convert to ICD-10 a few codes at a time. For other small and mid-sized specialty practices who aren’t fully prepared for the

This article discusses how the implementation of the new ICD10 codes are costing more than originally planned. All practices are required to use 2014-certified electronic health-record technology in order to receive funding from a federal electronic health record incentive program. The new estimates for the ICD10 implantation include the cost of such things as education, IT and documentation

There are two trends that I have learned about from UMA and TV. ICD-10 replacing IDC-9. ICD-10 will provide the medical billing/coder with more descriptions for describing encounters and hospital stay for patients. Where ICD-9 had 3,824 procedure codes and 14,025 diagnosis codes, ICD-10 on the other hand, has 71,924 procedure codes and 69,823 diagnosis codes that is a big difference. The affordable care act also made an impacted on billing/coding since more people are getting procedures done. These procedures will need to be coded and documented for doctors and hospitals to get paid.

To guarantee that its members receive appropriate, high level quality care in a cost-effective manner, each managed care organization (MCO) tailors its networks according to the characteristics of the providers, consumers, and competitors in a specific market. Other considerations for creating the network are the managed care organization's own goals for quality, accessibility, cost savings, and member satisfaction. Strategic planning for networks is a continuing process. In addition to an initial evaluation of its markets and goals, the managed care organization must periodically reevaluate its target markets and objectives. After reviewing the markets, then the organization must

Health care cost has risen dramatically in the last decade. Health care plans have been forced to look at the quality of health care given by the providers so they can implement certain strategies to help reduce heath care costs. Managed Care describes a group of strategies that is looking to reducing the costs of health care for health insurance companies. (Kongstvedt 2007)

6). We are able to see how these significant events impact us even now. As our health care system continued to evolve, the 1990s saw health care delivery and financing primarily controlled by indemnity insurers, nonprofit hospitals and private physicians (Gabel, 1997, p. 134). Health insurance premiums grew by 20% and enrollment grew from 36.5 million to 58.2 million (Gabel, 1997, p. 134). With the growth of managed care plans, hospitals began to merge and the development of large physicians group practices evolved (Kongstvedt, 2016, p. 14). These roots of managed care grew to give us the health care system we are familiar with now.

At one point, managed care was the viewed as a resourceful tool in efforts to help assist employee, physicians and hospitals with quality health care, while controlling the cost of medical care in the United States. Over the past 30 years, managed care has been in the limelight of health insurance, as a dictator of how it will pay for medical bills. There have been many factors playing a role with managed care over the years. For example, due to the slim selection of options that are available with physicians in rural areas, and limited physicians to choose from, does this compromise the quality of care of each member or does this cut off services for members

As necessary as ICD-10 is, smaller practices that only have a few physicians on staff will have more of a difficult time integrating the system than larger organizations. The reason being that larger healthcare organizations tend to have coders. Coders are individuals who hardly ever have contact with patients but they are important in the sense that they are the ones that input the ICD codes into patients’ medical records. Without coders, physicians would have to be the ones to input the ICD codes into the patients’ medical record. Luckily physicians at hospitals and other large health organizations do not need to do this. Unfortunately, physicians at smaller organizations do not have coders at their disposal and they are the ones that enter the ICD codes.

Suggest the key financial drivers that most likely will cause health care organizations to merge. Provide support for your rationale.

In today's modern world with plenty of technology, it is hard to believe that we cannot figure out how to reduce Medical errors. The issue of medical error is not new in health care organizations. It has been in spot light since 1990's, when government did research on sudden increase in number of death in the hospitals. According to Lester, H., & Tritter, J. (2001), "Medical error is an actual or potential serious lapse in the standard of care provided to a patient, or harm caused to a patient through the performance of a health service or health care professional." Medical errors

Electronic medical records had a great impact in the ushering in of the age of Nursing Informatics. (Himss, 2010)EMRS present healthcare professionals with the ability to retrieve and organize data in a quick and efficient approach. With information so readily available, patient safety increases and we know that patient cost goes down. This happens because patient medications, allergies, history, demographic, and treatment information is more collectively available.

Having a single view of the patient and their treatment and recovery plan is invaluable in ascertaining which are the most and least effective tactics in treatment. The 360-degree view of the patient and the many processes supporting them is crucial for increasing the accuracy, effectiveness and performance of treatment programs over time (Blakeman, 1985). Computerized management systems are critical for organizing, analyzing and translating the massive amount of data captured on patients, treatment and recovery processes, and the use of supporting IT systems to optimize patient health and organizational provider performance (Peshek, Cubera, Gleespen, 2010). The ability to aggregate and intelligently use all available data, information, patient-based and process-generated data to deliver higher levels of quality care is possible when computerized management systems are used throughout healthcare organizations.