There are variety types of practices
There are variety types of practices
Health care access is very important. It allows all people to get care from many different places around the world. There are many ways that access to health care impacts the people who use it. Heath care access impacts, the physical, social, and mental status of people, the prevention of disease and disability, treatment of conditions, quality of life, and life expectancy (Access of Health Services, 2016). For people to have access to quality health care it is vital that health insurance provides adequate coverage, service, workforce, and provide it in a timely manner.…
Accountable care organization is described as an organized group of providers that coordinates the care for designated beneficiaries in the traditional Medicare fee for service program. Who are the members of the ACO? According to the Centers for Medicare & Medicaid Services, members of ACO are a group of doctors, hospitals, and other healthcare providers who volunteer to coordinate quality care especially to elderly. ACO focuses more on chronic conditions that involve high cost (Kongstvedt P 2016 ). The Uncontrolled cost of health care brought American health care providers and payers effort to bend the cost curve and moderate the growth of cost.…
Health Care Accountable Care Organization Model- Alliance ACO MHA 536 Strategic Leadership in Healthcare Candice Cole 04/12/2017 Introduction The advent of medical advancement has grown over the past decades. The access to this technology is also limited depending on the level of Health care services in a certain country. ACOs or Accountable Care Organization is specifically available in the United States.…
Accountable Care Organizations must also satisfy specific quality measures as outlined by the Centers for Medicare and Medicaid. The provider will measure their performance by patient outcome to ensure quality measures are met or surpassed. Health and Human Services (HHS) has also offered incentives to providers through shared savings programs. HHS has developed monetary rewards for providers that can prove saving as a result of using ACOs. Upside Shared Saving Program is common with the Medicare Shared Saving Program (MSSP).…
A major component of the 2010 Patient Protection and Affordable Care Act (ACA) is the promotion of new models for payment and care delivery that control costs while improving quality. One of the most prominent of these new models is the Accountable Care Organization (ACO). ACOs, broadly defined, are groups of health care providers and hospitals joined together as either vertically integrated systems or virtually integrated networks that are responsible for the care of a defined population of patients. A primary means through which the ACA promotes the ACO model is the Medicare Shared Savings Program (MSSP), in which ACOs contract with Medicare to provide care to beneficiaries in the Fee-For-Service program, and are financially rewarded if…
As of 2010 the majority of private and public payers have committed themselves to having their provider payments incorporate both quality of care and efficiency. (www.ajmc.com) In the United States, according to the article written in PubMed, “a number of communities are adopting a managed care approach to caring for the low-income and uninsured individuals”. These communities have a system that is studying their health and tracking their wellness programs of those communities. This will greatly improve and create a design to help ensure access to primary and preventative care for the low-income group.…
With the introduction of the Affordable Care Act (ACA) there have been many recommendations to improve the health care of all Americans. These recommendations are designed to expand coverage, hold insurance firms accountable, decrease the cost of health care, offer more choices, and enrich quality of care. While these recommendations are aimed at patients, nurses will inevitably be affected in the way they give care. The ACA has proposed three models of care that are designed to reduce costs and provide a value-based health care system. These models are the Accountable Care Organizations (ACOs), the Medical/Health Homes, and the Nurse-Managed Health Clinics (NMHCs).…
List several efforts that have been enacted by payors to control costs. The following are efforts that have been made by payers to control costs: Reduce avoidable, ineffective and duplicate use of services - including technology that does not improve patient care - and encourage clinically effective care based on comparative effectiveness research and implementation of IT, To pay appropriately and foster the adoption of innovative models of health care delivery, To ensure accurate pricing of services, To ensure an appropriate physician workforce specialty mix, To reduce administrative costs, Reduce costs from medical malpractice and defensive medicine Explain the ramifications of allowing/disallowing an individual to be able to sue his or…
1.2 There are four approaches to outcome based practice - results based accountability, outcomes management, outcomes into practice and the logic model. Results based accountability, also known as outcome based accountability is an approach which uses data to problem solve and make decisions, such as a feedback system. It is often used to look at communities to improve the lives of children, youth, families, adults and communities as a whole. It is also used within services to improve performance. Results based accountability works backwards starting with the desired end outcome and is a means to getting past talking about problems and finding solutions to make improvements.…
This occurred when the Affordable Care Act (ACA) of 2011 included provisions to help promote clinical integration. In general, the act suggests that hospitals and health care organizations are expected to collaborate and improve clinical integration or the coordination of care across settings by expanding coverage, boost the effectiveness and efficiency of care, promote innovation, and control costs. Collaboration is comprised of physicians, hospitals, and other providers that share the responsibility and information about patients as they transition from one setting to another over the entire course of their care. Clinically integrated providers work together to develop and implement evidence-based clinical protocols, focusing on delivery of preventive care and coordinated management of high-cost and high-risk patients. The combination of these results allows these providers to identify opportunities for improvement and ensure adherence to protocols by utilizing shared information and technology to conduct ongoing clinical care…
The Patient Protection and Affordable Care Act mandated several types of new arrangements of care. One of these is the Accountable Care Organization (ACO). Explain what ACOs are, whom they serve, and how they are supposed to reduce costs of care. ACO is an organization that consist of doctors, suppliers of health care e.g hospitals, clinics, all health care services, and anyone involved in patient care to provide the best possible care for all medicare patients. This model was adopted by the Affordable Care ACTwith the number one goal of providing timely, accessible and appropriate care for all medicare patients.…
In 2014, state- and federally administered health insurance marketplaces were established to provide additional access to private insurance coverage, with income-based premium subsidies for low- and middle-income families, and federally subsidized expansion of Medicaid eligibility was made available in states choosing to participate. While it is too early to measure the impact of all of the various components of the ACA, studies already have found evidence that the number of uninsured adults has declined by about 9.5 million from July–September 2013 to April–June 2014 (Collins, Rasmussen, and Doty, 2014). Early evaluations of Medicare ACOs have also found promising results with regard to quality improvement and savings (CMS, 2014b). As of January 2015, Medicare will pay for doctors to coordinate the care of patients with chronic conditions. To be eligible for an extra $42 per patient, doctors will have to draft and help carry out a comprehensive plan of care for each patient who signs up for one.…
The Affordable Healthcare Act (ACA) was signed into law on March 23, 2010, and has since affected the practice of healthcare in the United States (U.S. Department of Health and Human Services [USDHHS], 2014). The ACA has had significant impacts on health care by requiring health care providers to be completely digital to allow for better access to patient histories and expanding coverage to those who may previously not have had access to healthcare (USDHHS, 2015). The current law is trying to improve quality and lower health care costs while providing better access to health care (USDHHS, 2014). While the law seems to be working well for patients, there are several factors that affect healthcare providers and organizations, which has caused…
With everyone having health care coverage and the ability to choose where to go for health care needs, facilities will be competing to gain the trust and respect of the public to be the most often chosen health care provider. An organization that is dedicated to putting patients and their needs first, offers the most current and precise care, focuses on prevention, has strong leadership, and is cost-effective will stand out. A facility that is managing employees in a productive manner and having happy, skilled, and proficient caregivers who provide safe, quality care is a must for achieving the best clinical outcomes. Additionally, being focused, setting achievable goals, and meeting goals is crucial for health care providers to be successful. It helps keep employees engaged, focused on the mission and values of the organization, and contributes to advancing health care as a…
To identify the linkage between quality health and services provided against improved health care, HEDIS utilizes the administrative data central to quality improved with health care quality measures and treatment identification strategies based on diagnosis, treatment and procedure codes and determines the validity of the data (Harris, Reeder, Ellerbe & Bowe, 2011). The positive outcome of quality measures like HEDIS is that it improves the health status of patients, decrease morbidity and saves money. In addition, these quality measures have been developed around health care interventions where there is sound scientific evidence of effectiveness (Williams & Torrens, 2008). The rapid aging population and the greater longevity of people with chronic conditions will require organizations to coordinate care in order for them to deal with this challenge, health policy and professionals are pushing disease management programs (i.e. integrated care, shared care, care management) to enhance quality and continuity of care for the chronically ill (Pay-for-performance in disease…literature, n.d., 2011). In 2005, these HEDIS measures targeted a study of 3.3 million and…