need to be followed and addressed. Health care facilities are required to report adverse events to the health department including a corrective action plan. Reporting adverse events to the health department aids in adverse event monitoring as well as improving patient safety. Legal Requirements of Health Care Reform and Their Impact on Patient Care . Health care reform has been a major topic of discussion in recent decades. Health care laws such as HIPAA in the 1990s created standards for the exchange of medical records and created protections for individuals to retain their health insurance plans when leaving their employer. However, the most important health care reform legislation of the last 10 years impacting patient care is the Patient Protection and Affordable Care Act (ACA). The ACA came with sweeping legislative reforms; however, one of the main aims of the ACA is to improve health care value and quality. According to Rosenbaum (2011), the ACA requires qualified health plans to “meet federal standards related to provider network sufficiency…and health-care quality” (para. 13). While this area of reform directly impacts insurers, its effects inevitably impact health care providers in terms of implementing higher standards of quality and becoming
5 accustomed to new reimbursement methods. Furthermore, Rosenbaum (2011) explains that one of the goals of the ACA is to realign the entire health care system for long-term changes in quality. Part of how the ACA does this is by changing Medicare and Medicaid in terms of payment method and service delivery requirements, such as mandating the creation of accountable care organizations. These changes “slowly but forcefully” nudge the health care system into behaving in different ways (para. 15). All of these changes impact the quality of care that patients receive, starting with Medicare and Medicaid recipients, so that health care is both more affordable and of higher quality. Strategies That May Help Avoid Malpractice . Medical malpractice cases cost the health care system billions of dollars per year. These cases have a financial effect on the patient, the physicians, and the insurance company, and to prevent being sued doctors may order extra tests, more procedures, or request more consultations with the patient. These measures are referred to as defensive medicine. Physicians who practice defensive medicine do so because they feel it may lessen their chances of being sued. Although
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- Fall '14
- Health care provider, health care reform, Medical malpractice