Watson Medical Reimbursement

In today’s society, the accuracy of health information, the availability of health records, and the professional resources in which one live are vital in decision making for health conditions. Meaningful Use (MU) is a program developed by CMS Medicare and Medicaid that awards, incentives in the health care industry in which the certified electronic health records (EHRs) are used to improve patient care (Practice Fusion, 2016). These incentives are for professionals that care for about 30% of their adult patient volume or 20% of their children’s volume for Medicare and Medicaid patients (CMS, 2016). In addition, adjusting from paper charts to electronic charts of patient’s information is beneficial for MU. Furthermore, the American

Technology is being used everywhere in the world. For example, technology is used to make cars, clothes, eye glasses, to teach and now it is utilized in health care every day. Technology plays a major role in the health care reform Act to reduce costs, improve access, and save lives. The Patient Protection and Affordable Care Act , and its constitutionality ruling by the United States Supreme Court last June 28, 2012, mandates requiring all electronic medical records for all health care agencies in 2014 ( Jha, 2013, p 1628) . David Blumenthal (2009) surveyed all acute care hospitals in the American Hospital Association and found only 1.5% of U.S. Hospitals have comprehensive electronic medical records system. Also included in the Patient

Healthcare stakeholders know how to value what they have captured and they have come up with many ideas to help with their goal. “Big data could transform the healthcare sector, but the industry must undergo fundamental changes before stakeholders can capture its full value” (Kayyali, B., Knott, D., Van Kuiken, S., 2013). Since the affordable care act has been in place there has been an increase number of patients seeking preventative care or even seeking help for chronic illnesses that they weren’t seen for because of lack of insurance. Because of that, there has been a shortage of physicians, nurses and other healthcare providers. So the stakeholders have another challenge on their hands in trying to hire more doctors and nurses to help with the increase of patients.

With the growing ability of organizations to capture and analyze large batches of data, there are ever-increasing possibilities for the development of healthcare studies utilizing Big Data’s promise of advancement in data processing. These tools can benefit the field of healthcare by treating data as an asset to be managed, as well as providing new insights into genomic development of large populations that were previously not fathomable. The health care industry is one sector of the economy where data analysis presents great opportunities for improvement in the quality of services provided, but with these possibilities come great challenges in collecting, utilizing, and education the next generation of data stewards, and the NIH is sure to look to global models for data quality in carrying out their new directive.

Patients are taking an aggressive role in their healthcare needs. Patients desire to in touch with their medical records. Medical professionals are utilizing the Electronic Health Records to implement current data into information necessary to provide quality care for the patient. Thereby, managing patients’ current, and past histories. To understand what is occurring today, one must recognize why patients are taking an active approach to their healthcare.

Health information technology (HIT) is revolutionizing the way we interact with health-related data. One example of this is the obvious rise in

How data is captured varies from institution to institution. In order for data to be well understood, data should have a definition that is consistent and comprehensively understood by all users of the data. Standardization of how data is captured is critical to allow the production and export of data needed to support quality assessment, decision support, exchange of data for patients with multiple health care providers and public health surveillance. Patient safety and quality improvement are dependent upon embedded clinical guidelines that promote standardized, evidence-based practices. Unless we can achieve standardization with terminology, technologies, apps and devices, the goals of EHR implementation will not become a

Based on the political and economic environments of states and the federal government the methods of health care reimbursement have been required to evolve. With the introduction of the Patient Protection and Affordable Care Act (PPACA) new laws have been set into place that has caused a stringent review of spending on health care. All care provided is being examined for effectiveness, quality, and the actual need of the service. Unnecessary health care functions are being screened and eliminated. The government and other insurance providers have begun to place cost containment measures in place only paying for those procedures that are deemed medically necessary for the illness that the patient is currently afflicted with. This has a direct impact on the monies that the government and insurance providers will reimburse for services. The following paper will look at the major types of reimbursement activates currently in place. The writer of this paper will also speculate on the future of health care reimbursement and how it will affect his current organization.

The ARRA includes the Health Information Technology for Economic and Clinical Health (HITECH) Act, which pursues to improve American Healthcare and patient care through an extraordinary investment in Healthcare IT (HIT). The requirements of the HITECH Act are precisely designed to work jointly to provide the necessary assistance and technical operation to providers, enable grammatical relation and organization within and among states, establish connectivity in case of emergencies, and see to it the workforce is properly trained and equipped to be meaningful users of certified Electronic Health Records (EHRs). These computer software products are designed collaboratively to intensify the footing for every American to profit from an electronic health record (EHR) as part of a modernized, interrelated, and vastly improved grouping of care delivery.

The American Recovery and Reinvestment Act was created in 2009 to try and help multiple systems in the failing economy. The main goal of this Act is to promote economic recovery, spur technological advances in health and to stabilize state and local budget. The clinical business intelligence improves the patient care process, this data analytics provide the quality data which is timelier, and it also helps in billing and supports clinical

The healthcare industry is in the midst of a major change from paper based medical record keeping to electronic medical record keeping. As part of the American Recovery and Investment Act of 2009, the Health Information Technology for Economic and Clinical Health (HITECH) Act was passed (Office of the National Coordinator for Health Information Technology, 2014). HITECH is the U.S. Government’s first major contribution to the change from paper to electronic health information technology by setting meaningful use incentive program for Medicare and Medicaid providers that met certain requirements. Healthcare professionals that meet the meaningful use criteria will be awarded financially, and those that don’t meet the 2015 guideline will be penalized. We live in an electronic world of instant access to information and by adopting health information technology we give providers better and easier access to more information which in turn allows them to make a more informed diagnosis and treatment plan for the patient. The electronic health record (EHR) is part of the new information technology. According to the Office of the National Coordinator for Health Information Technology (2014.), EHR’s provide many benefits such as improvement in the quality of patient care; improvement in the coordination of patient care; more accurate diagnosis and better outcomes; a higher level of patient participation in their own care; and cost savings for the practice

Chaudhry et al. (2006) identified that informatics systems will be necessary in obtaining this data to meet the new data requirement to ensure quality and efficiency, and document actual outcomes. Optimizing care by enhancing integration of technology support to facilitate work flows and provide data that supports both the point of care delivery as well as the perspective on organizational performance will be critical for

With the increase in information technology, it has allowed data to be accessed almost anywhere in the world. Gone are the old ways of looking at data such as going to a data resource centers. In the medical world, Health information technology (HIT) open up vast new opportunities to physicians and medical care providers all over the world. The introduction of Electronic health records (EHR) allows healthcare providers to record patient data digitally and can assist in health care delivery. With EHR being readily available, they can increase the health and span of an individual’s lifetime regardless of socioeconomic status. When looking at American health care, the OECD has the US as one of the worst developed health care systems and a large part of it is due to our health information technology. Health care

The government instigated the change, technology designed an application to manage and control the data, now it’s left to the healthcare industry to configure a business strategy for using data analytics to improve the outcomes related to the patient, secure population data and the improve the business of healthcare performance. What do all three have in common – survival?

One major big data system implemented in healthcare today is Electronic Health Records (EHR). CMS.gov describes EHR as,