Reimbursement and Pay-for-performance Theresa Kilgo HCS/531 December 16, 2013 Dr. Rachael Kehoe Reimbursement and Pay-for-performance There are a lot of problems within the health care system that State, Federal, and Local governments are trying to correct the matter by moving away from the fee-for-services model and move to the pay-for-service model. One of the problems is cost and efficiency of health care, and one of the ways that they are trying to fix the problem is with pay-for-performance. That can be defined as an incentive that provide financial funds to health care providers to carry out improvements focused on achieving prime patient issues, this program is widespread and many states have adopted the program, and many have a report that they have seen an increase in quality of care. This program was created to improve the healthcare systems, however, many authors have different meanings and roles of pay-for-performance but all agree on the definition and function of the program, “the objective of pay-for-performance initiatives is to link reimbursement to quality and efficiency as an incentive to improve the quality of health care, as well as reduce system wide costs” (Shi & Singh, 2012, p. 237). There are a lot of pros and cons of pay-for-performance in health care (see appendix for charts.)
Some ways health care changes have affected my role is the focus on patient and family centered care. Patients presenting for emergency treatment are most concerned with the patients needs. By requesting insurance information on arrival, families are often made to feel as though they will be mistreated if uninsured or if insured through government issued health coverage, as opposed to private health coverage.
In what further ways can professionals across primary care and public health work together to improve early diagnosis rates? Following cuts in funding and staffing from the old system of networks, how effectively are clinical senates and networks proving in informing commissioning decisions and in improving quality? What impact is cancer registration data having on improving outcomes in preventing premature mortality? How can the challenges of reducing inequalities in cancer services and outcomes ‐ such as regional variations in the prevalence of public health issues ‐ be
What changes can we make that will result in improvement? The team must be able to identify the changes that are most likely to lead to an improvement (“Institute for Healthcare Improvement,” n.d.). Once these questions have been answered, the team can begin implementing the second part of Deming’s model. Deming’s Model: Part Two Plan: The team needs to understand what the current problem is and what makes the current process insufficient. During this phase, the team will determine how much improvement is required, what change will be implemented, how the effects will be measured, and what or who will be affected by the change (“The Deming Cycle,” n.d.).
Patient Privacy HCS 335 February 18, 2014 Patient Privacy In today’s health care organizations, patient privacy is a major problem within the health care system. Current improvements in technology have reformed the provision of health care and the systems used to record and retrieve health information. During the course of this paper, it will discuss the affect patient privacy has on the community and legal and ethical issues associated with patient privacy. It will also discuss managerial duties as well as proposed solutions to maintain patient privacy. Health care professionals have an obligation to protect the rights to patient privacy when it concerns patient’s personal and medical information.
Its Primary purpose is to ensure quality patient care and managing the cost of that care. Its secondary purpose as defined by the Institute of Medicine (IOM) deals with individual users for education, regulations, policies and public health from data entered, verified, corrected or analyzed directly or indirectly. Homeland Security has recently been added to the list of users, including patient care providers, managers and staff, coders and patients themselves. Patients can make changes as necessary. Other users might include lawyers, employers, law enforcement and researchers.
Some people may have very similar needs when it comes to treatment and or care but before new treatments and care plans are introduced it is important to carry out a research project or study to investigate the benefits of others. Charities and organisations whose purpose is to raise awareness and improve the care of individuals with illnesses, diseases or disorders can base and focus their research on better diagnosis so that they can identify people’s needs earlier as they can then start to help the patient/client by ensuring the correct treatment is given to them as soon as possible. Highlighting the gaps in provision Highlighting the gaps in the provision that is already available is important for health and social care workers also. This is because that gap could be affecting a huge amount of people who are ill or need assistance and can’t get the help that they need because the services just aren’t available to them. The needs of communities are constantly changing and new gaps in provision appear over time.
1:1 Analyse 3 Definitions Of Health For our society to develop an understanding of health and how to improve it, we first have to define health and what it is to be healthy. There are many factors that influence our definition of health, the four main ones that influence definitions are age, culture, gender and social class. There are different models of health that professionals use when deciding whether someone is healthy or not. What is health? What is meant by the definition “Health?” Below are 3 examples as defined by some of the leaders in health promotion.
Crystal McDaniel HCS/320 March 18, 2014 Rafael Gonzalez This paper is an individual communication opinion paper that will talk about effective communication in healthcare. Effective communication enables a person to communicate both positive and negative information without creating conflict or destroying trust within a working relationship. I will begin with the basic elements of communication and how they are different from the basic rules of healthcare communication. Then I’ll discuss how a care provider can encourage a reluctant consumer to communicate effectively and how cultural differences influence communication. How does effective communication incorporate the basic elements of communication?
Health Promotion in Nursing There are various definitions that apply to health promotion. Health promotion can be “the science and art of helping people change their lifestyle to move toward a state of optimal health.” (Edelman, 2014, p. 12). According to Edelman there happens to be a more complex definition that was commissioned by the U.S. Public Health Service stating health promotion is ““the process of advocating health in order to enhance the probability that personal (individual, family, and community), private (professional and business), and public (federal, state, and local government) support of positive health practices will become a societal norm” (Edelman, 2014, p. 12). Health promotion applied in nursing practice is vital for patients. Nurses apply health promotion everyday to their patients wither they realize it or not.