Health-Care Regulation Assignment Essay
Topic 8 DQ 1
Which of the current trends in health care regulation reform will have the most positive influence on quality of care and organizational sustainability? Why? Which trends will have the most negative influence? Why?Health-Care Regulation Assignment Essay
Topic 8 DQ 2
Consider the information presented and discussed in this course regarding health care policies, procedures, reform, and regulation. What might you propose to increase equality and create changes to improve the American health care system? Support your ideas. How might these proposed ideas influence your dissertation research? Explain.
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.Health-Care Regulation Assignment Essay
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.Health-Care Regulation Assignment Essay
It can be overwhelming to know and understand all the regulations that apply to the health care industry and to know which regulatory agency is responsible for the enforcement of certain requirements. Because it can get confusing, and because it’s so important that we understand who does what and why, I thought it was time to talk about regulations, to break down the regulatory agencies who govern and have oversight for health care and review why they’re important and how they impact each of us on a daily basis.
Regulation plays a major role in the health care industry and health care insurance coverage. The various regulatory bodies protect the public from a number of health risks and provide numerous programs for public health and welfare. Together, these regulatory agencies protect and regulate public health at every level. Health care regulations are developed and implemented not only by all levels of government (federal, state and local) but by private organizations as well.
Health care regulations and standards are necessary to ensure compliance and to provide safe health care to every individual who accesses the system. The health care regulatory agencies in turn monitor practitioners and facilities, provide information about industry changes, promote safety and ensure legal compliance and quality services.
Federal, state and local regulatory agencies often establish rules and regulations for the health care industry, and their oversight is mandatory. Some other agencies, such as those for accreditation, require voluntary participation but are still important because they provide rankings or certification of quality and serve as additional oversight, ensuring that health care organizations promote and provide quality care.Health-Care Regulation Assignment Essay
Here in Maryland, the Office of Health Care Quality (OHCQ) is the agency within the Department of Health & Mental Hygiene charged with monitoring the quality of care in Maryland’s 14,000 health care and community residential programs. OHCQ licenses and certifies the majority of the state’s health care facilities, uses the state and federal regulations that set forth minimum standards for provision of care and conducts surveys to determine compliance. OHCQ also educates providers, consumers and other stakeholders through written materials, presentations, its website, conferences and seminars.
With Congressional oversight, United States health agencies develop laws designed to protect public well-being. The Department of Health and Human Services (HHS) oversees the general health issues and concerns of all American citizens, spearheading initiatives that improve public health and further medical research. In 2016, the mission of the HHS entailed improving patient outcomes and reducing medical costs. Throughout time, the HHS has worked toward such goals by supporting various new laws. As a result, the following eight acts of legislation have had a significant impact on health in America.
Healthcare Quality Improvement Act of 1986 (HCQIA)
The Healthcare Quality Improvement Act (HCQIA) provides immunity for medical professionals and institutions during conduct assessments. [1] The law originated partially due to a Supreme Court ruling involving abuse of the physician peer review process. To date, HCQIA continues to evolve as the act arises in courtrooms and justices deliver new rulings. Legislators enacted the law to protect medical professionals from peer review-related lawsuits and to encourage physicians to file official complaints after encountering unprofessional and dangerous peer conduct.Health-Care Regulation Assignment Essay
medicare
The Medicare program provides insurance coverage for almost 50-million American citizens. [2] In 1945, President Harry Truman rallied Congress for funding to insure all United States citizens. Twenty years later, president John F. Kennedy finally succeeded in providing coverage for U.S. senior citizens. Today, the Congressional Budget Office forecasts that the program will survive indefinitely thanks to sweeping spending reforms.
Medicaid
President Johnson’s 1965 legislation also included a provision to provide insurance for low-income individuals. [3] Today, Medicaid provides coverage for over 70-million American citizens. In 2014, the program reimbursed hospitals for almost 50-percent of all medical expenses.
Medicaid covers various recipients, such as uninsured expectant mothers, temporarily unemployed workers and disabled individuals. Recently, new legislation has lowered the nation’s uninsured rate to under 9-percent, representing the highest coverage rate in U.S. history.Health-Care Regulation Assignment Essay
Children’s Health Insurance Program (CHIP)
Along with the Medicaid, the Children’s Health Insurance Program (CHIP) has created a strong foundation for delivering health coverage to children living in low-income households. The program originated with the Children’s Health Insurance Authorization Act of 2009 (CHIPRA) and has successfully provided services to many previously disqualified clients. The program has an extensive history of providing insurance to underprivileged children and receives funding from respective states and the federal government. Today, the Affordable Care Act (ACA) makes this service accessible to the largest number of low-income children in the country’s history.
Hospital Re-admissions Reduction Program (HRRP)
The Hospital Re admissions Reduction Program (HRRP), an Affordable Care Act initiative, requires the Centers for Medicare and Medicaid Services (CMS) to reduce payouts to care facilities that experience excessive patient readmission’s. [4] The program launched in late 2012 and defines readmission’s as ‘repeat patient admissions among participating CMS hospitals in a 30-day period; allowing exceptions for specific conditions, such as heart failure and pneumonia, as well as factors such as poor health and multiple illnesses.’Health-Care Regulation Assignment Essay
Health Insurance Portability and Accountability Act (HIPAA) of 1996
The Health Insurance Portability and Accountability Act (HIPAA) protects America workers by allowing them to carry health insurance policies from job to job. [5] The program also permits workers to apply to a select group of health insurance plans to replace lost coverage and adjust for family changes such as marriages, births and adoptions.
HIPAA bars insurers from discriminating against policy applicants due to health problems. In some instances, if an insurance company denies a worker’s application, the individual may apply for coverage outside of the normal enrollment period. Additionally, the act preserves state laws that protect workers’ insurance rights.
Patient Safety and Quality Improvement Act (PSQIA) of 2005
The Patient Safety and Quality Improvement Act (PSQIA) protects health care workers who report unsafe conditions. [6] Legislators created the law to encourage the reporting of medical errors, while maintaining patients’ confidentially rights. To ensure patient privacy, the HHS levies fines for confidentially breaches. The law also authorizes the Agency for Healthcare Research and Quality (AHRQ) to publish a list of patient safety organizations (PSOs) that record and analyze patient safety data. The Office for Civil Rights (OCR) enforces the law among national health care facilities.Health-Care Regulation Assignment Essay
Affordable Care Act of 2010
In March 2010, president Barak Obama sanctioned the Affordable Care Act (ACA), a somewhat modified version of the all-inclusive coverage imagined by presidents since the early 1900s. [7] The act requires most U.S. citizens to apply for health insurance coverage, levying a penalty for individuals who fail to secure insurance but making exceptions for a few protected groups. Under the law, enterprises that employ more than 200 workers must provide health insurance coverage. The act also established the American Health Benefits Exchange, where citizens can review and compare insurance plans.
The Affordable Care Act offers health care professionals the opportunity to participate in shaping the delivery of patient services. The medical field can benefit from input that helps deliver better services to the growing patient population while reducing care expenses. As a current or future decision maker in the health care field, care providers must reflect on how to create these results at their respective workplaces.Health-Care Regulation Assignment Essay