HEALTH CARE ASSIGNMENT QUESTIONS 5
HealthCare Assignment Questions
Itis difficult and frustrating for any health care organization tounderstand the issues surrounding regulatory compliance. WiregrassMedical Centre in the United States is one of the health centers thatis unable to meet all the relevant regulatory requirements. The shortterm effect that Wiregrass Medical Center can use in order to comeinto regulatory compliance is by establishing standards of care(Cleverly & Song 2011). This is essential in controlling riskduring implementation and development of new treatment regimens.Understanding professional practices is necessary when reviewingprofessional liability exposures. A long-term action that wouldensure that Wiregrass achieves these regulatory compliance is byensuring that their processes are done in a cost effective approachand timely way. Consumer satisfaction is measured by the quality ofcare provided to them. This provides a guide on what data is to becollected, methods and how it is analyzed and recorded.
Allthe regulations are crucial because the success of Wiregrass MedicalCenter depends on the compliance with regulatory requirements. TheMedical Center should conform to legal requirements so as to conductbusiness as well as offer goods and services (Cleverly & Song2011). Regulatory standards are among the requirements expected byauthorized agency in order to address competence. In an attempt foran organization to prioritize its efforts, the government has imposednumerous disciplinary and licensure mandates. They should be clearlyunderstood by managements as well as the human resource personnel ofany organization.
Healthcare organizations should develop their performance measurementsystems by following established rules in the organizations. Changesin nature of health organizations such as pressure toreduce expenses, improve quality of care and meet deadlines haveenabled healthcare practitioners to evaluate their performance.
Thecomponents of performance management systems that are most importantinclude structural, process and results. The fundamental componenttest organization`s capacity and how care is provided byconcentrating on factors such as staff and information technologysystems (Cleverly& Song 2011).An example of structural component is the adoption of druge-prescribing. Process component measure how services are provided.It identifies whether the activities performed benefits patients. Anexample of process component includes cancer screening. Outcomemeasures the effects of healthcare. This include analyzing whetherthe patient`s condition improved after medication and whethersatisfaction was achieved (Cleverly& Song 2011).An example of result component includes average hemoglobin level ofpatient diagnosed with diabetes.
Thepart of performance management system that is considered leastimportant includes balancing measures. The component ensures that achange in one system does not affect other systems (Cleverly& Song 2011).An example such components include increasing regular visitcompliance for preventive care and ensuring that scheduling capacityis not exceeded.
Thefederal government started a demonstration named as Recovery Auditcontractor program in the year 2003. The main objective of this auditprogram was to identify and correct healthcare improper payments bydetecting and collecting the overpayments made to healthcare federalMedicare programs. The overpayment was on complaints of healthservices that were provided to beneficiaries of Medicare. Actionshave been implemented to prevent future improper payments todifferent states (Cleverly & Song 2011). The Benefits of theseAudit programs is that they ensure each Medicare provide services inan efficient and anti-fraud way. Further, they help examinereinsurance payment claims and whether the drug prescriptionssubmitting these claims incurred cost in excess of the allowed costs.
Thethird benefit of recovery audit contractors program is that they helpreview estimates forwarded by prescription drug plans in respect toenrollment of costly beneficiaries. It compares these estimates withthe number of beneficiaries who enrolled with such plans.
Inthe context of healthcare organizations, regulation refers to factorsthat govern the administration of Medicare and influencing thebehaviors in delivering healthcare services. The government regulateshealthcare organizations so as to guide their activities and achievethe national health goals. It ensures that equality is achieved,promotes social cohesion and increases economic efficiency (Cleverly& Song 2011). Different state and federal agencies focus onhealth care policies to implement public health programs and acts asregulatory oversight. Health Care Research and Quality is one of thehealth agencies. It supports research that will help improve qualityand results of health care. Further, it helps reduce costs andaddress client`s safety by eliminating errors (Cleverly & Song2011).
Theother agency is the Department of Healthcare Services. The aim ofthis organization is to improve the health status. It works closelywith county government to provide care to low-income earners andpersons with disabilities (Cleverly & Song 2011). The companyfinances numerous individual Medicare’s such as Child Health andDisability Prevention Program and Medical Assistance Programs. It isimportant for health care organizations to keep themselves up to dateby maintaining these regulatory requirements. Noncompliance can leadto the dissolution of these organizations due to heavy fines andlengthy court proceedings.
Cleverly,W. O., Cleverly, J. O., & Song, P. H. (2011). Essentialsof health care facilities.Sudbury, Mass: Jones & Bartlett Learning.