Centers for Medicare and Medicaid Services

negative impact on their financial position (e.g., higher debt to capitalization ratio). (Burns, Gimm, and Nicholson, 2005 pg 21). A more recent study has found that integration of health plans with providers (hospitals or physician groups) to serve the Medicare Advantage population is associated with higher plan premiums (Frakt, Pizer, and Feldman, 2013 p 21). Diversification is defined as the expansion of the firm across product, geographic, and customer markets. Firms have traditionally relied on this

Never Events and Hospital Acquired Infections Hospital is the place to go when someone is sick and requires medical attention. It is shocking to know that one can contract diseases while in the hospital facility which were not present during admission. And that ‘Never Events’ which are preventable incidents such as wrong site surgery do occur in the hospital setting. How do we prevent hospital acquired conditions and never events from occurring in the hospital? It will be interesting to figure

accreditation does not assure quality of care (Carroll, 2009). This analysis will evaluate the Det Norshe Veritas, Inc. (DNVHC) accreditation. This program is recognized by the Center for Medicare and Medicaid Services (CMS). This program serves as a condition to support reimbursement from Medicare and Medicaid for services rendered. This analysis will discuss the benefits of achieving accreditation and discuss differences between global and national standards. The analysis will conclude with a

of improving long-term care services through enhancing quality and patient satisfaction through appropriateness, ease of access, shared information, and ongoing continuity or care. This project proposal aims to improve avoiding performance gaps and duplications in accessibility and availability of services and defining the goal of inter-entity organization and management through continuous quality management. Project Goals Coordination of care means that services are corresponded to

What is Pay-for-Performance? Pay-for-performance is a payment approach which focuses on improving the quality of healthcare. This payment system focuses on providing financial incentives to providers who achieve health outcomes for their patients. Providers are typically evaluated on four metrics: ¥ Process. This pertains to health measures that have been shown to improve health conditions. For example, whether or not providers counseled patients to quit smoking (Baird, C., 2016). ¥ Outcome. This

management to offer the best quality of service;

Implications According to a study conducted in 2011 by the government, approximately 80% of urinary tract infections associated with indwelling catheters, increase the hospital length of stay by one to three days, and according to the Centers for Medicare & Medicaid Services (CMS), have an annual cost of

Care Long term care is a growing service within the health care system in the United States. Long term care is a complex system that helps individuals that can no longer perform normal daily activities. These individuals are comprised of the elderly, the disabled, and the cognitive impaired. There are a variety of long term care services and settings that are structured to fit the individualized needs for a patient. Long term care is defined as a variety of services that are individualized and coordinated

Regulatory Agencies Several regulatory agencies are responsible for licensing long-term care facilities to ensure compliance of laws and regulations. Regulatory agencies also receive and investigate complaints that are related to the facility and the services in which the facility provides (Walsh, 2014). All long-term care facilities are expected to abide by these regulations in an effort to ensure long-term care patients proper care, ethical treatment, safe living environments, and health care reimbursement

(Horwitz et al.,2011). It is important to consider an all-condition 30-day readmission rate as a quality measure which is the standard benchmark used by the Centers for Medicare & Medicaid Services (CMS) (Horwitz et al., 2011). Rates at the 80th percentile or lower are considered optimal by CMS. Patients transferred to another hospital for longer term care will not count as a readmission. A hospital's readmission rate is calculated