Week 5Individual Project HCM307.docx - Financial Trends...

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Financial Trends 1 Week 5 Individual Project: Financial Trends 6/21/2017 Candice Maldonado HCM307 Michael Green
Financial Trends 2 The Center for Medicare and Medicaid Services or (CMS) has become more involved in the reimbursement component of health care as a way to make certain that payments are tied to quality care that is being provided. With CMS being more involved in the reimbursement it is one of the major initiatives that Congress put in place in the Deficit Reduction Act of 2005 . “CMS is not asking hospitals to be guarantors against all possible adverse occurrences during a hospital stay,” Griffith says. “It is simply asking hospitals to make sure that hospital staff do what they should be doing anyway, like washing their hands before touching a patient, or observing other sanitary precautions. The underlying rationale is that neither Medicare nor the beneficiary should pay a hospital for the higher costs of treating a condition that was acquired during the hospital stay and that was determined to be reasonably preventable through compliance with widely accepted, evidence-based guidelines.” (ITC, 2017). I think that the choice of being more involved in the reimbursement component of health care is good for not only the insurance company but also to the patients that are receiving the care from the hospitals for things that could have been prevented by getting the proper care. The impact that CMS’s involvement with the reimbursement model at Healing Hands Hospital and other health care organizations is that it should not really impact them as long as they are doing their jobs and taking care of the patients and providing preventative care. I feel that all insurance providers should change their policies on reimbursement to stay universal and to keep hospitals and their staff accountable to the care that they are providing, to their patients. The tools that can be implemented to ensure organizations such as Healing Hands Hospital and physician practices are meeting the policies and procedures set forth by CMS is to do Audits, to see what exactly the organization is doing. It would be crucial to make sure that there is communication between all parties involved, as well as making sure that the services are
Financial Trends 3 affordable, and knowledge is key on how to help patients. There could be news letters that go out for communication and any new policies that come out so everyone is aware of new processes. Those are some of the tools that can be used to ensure that organizations such as Healing Hands Hospital and physician practices are meeting the policies and procedures set forth by CMS. “It’s too early to measure changes and is thus not yet clear whether the new CMS policy will reduce the incidence of hospital-acquired infections (HAIs), but CMS has heard anecdotal information suggesting that hospitals are taking this policy very seriously and are implementing greater prevention steps.” (ITC, 2017).

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