The Center for Medicare and Medicaid Services (CMS) has taken on a more visible role in health care. Great deals of changes have transpired to improve patient safety along with the implementation of additional quality metrics.
The Patient Protection and Affordable Care Act has begun to change the reimbursement fees/structures of Medicare and Medicaid reimbursement for health care services.
For this assignment, write a 500-word presentation that you will deliver to your organization’s board of trustee members on how the new reimbursement structure will impact the organization’s revenue structure. In your presentation, address the following questions:
- Why did CMS become more involved in the reimbursement component of health care? How does their involvement impact health care organizations?
- What tools can be implemented to ensure an organization is meeting the policies and procedures set forth by CMS?
- Identify 3 tools from the CMS Web site that are helpful to achieving the goals set forth by your organization.
has taken on a more visible role in health care. Great deals of changes have transpired to improve patient safety along with the implementation of additional quality metrics.
The Patient Protection and Affordable Care Act has begun to change the reimbursement fees/structures of Medicare and Medicaid reimbursement for health care services.
For this assignment, write a 500-word presentation that you will deliver to your organization’s board of trustee members on how the new reimbursement structure will impact the organization’s revenue structure. In your presentation, address the following questions:
- Why did CMS become more involved in the reimbursement component of health care? How does their involvement impact health care organizations?
- What tools can be implemented to ensure an organization is meeting the policies and procedures set forth by CMS?
- Identify 3 tools from the CMS Web site that are helpful to achieving the goals set forth by your organization.
APA format
2 ref
Expert Solution Preview
Introduction: The Center for Medicare and Medicaid Services (CMS) has taken an active role in healthcare and has implemented various changes to improve patient safety and quality metrics. Recently, the Patient Protection and Affordable Care Act has affected the reimbursement fees and structures of Medicare and Medicaid reimbursement for healthcare services. This presentation aims to discuss how the new reimbursement structure will impact the organization’s revenue structure and answer the following questions:
1. Why did CMS become more involved in the reimbursement component of healthcare? How does their involvement impact healthcare organizations?
CMS became more involved in the reimbursement component of healthcare to ensure that healthcare services were provided to patients in a cost-effective manner. Additionally, CMS aims to provide high-quality healthcare services to patients enrolled in Medicare and Medicaid. The involvement of CMS impacts healthcare organizations as they need to comply with CMS policies and procedures to receive reimbursement fees. If healthcare organizations fail to meet CMS policies’ standards and procedures, it can result in reduced reimbursement fees, negatively impacting the organization’s revenue and profitability.
2. What tools can be implemented to ensure an organization is meeting the policies and procedures set forth by CMS?
To ensure that healthcare organizations meet CMS policies and procedures, the following tools can be implemented:
a) CMS Survey and Certification: This tool provides information on CMS regulations and procedures to the healthcare organization. The survey and certification reports and accreditation information can be used to ensure compliance.
b) Quality Payment Program (QPP): QPP is a tool that outlines the requirements and guidelines for healthcare organizations to participate in CMS’s reimbursement program. Healthcare organizations can use it to understand their responsibilities and requirements to comply with CMS policies and procedures.
c) Data Analytics: Data analytics can be used to identify areas requiring improvement in healthcare organizations. By analyzing data, healthcare organizations can identify gaps and take corrective measures to ensure compliance with CMS policies and procedures.
3. Identify 3 tools from the CMS website that are helpful in achieving the goals set forth by your organization.
The following three tools from the CMS website can be helpful to achieve the goals set forth by the organization:
a) CMS Quality Measures: This tool is useful for healthcare organizations to identify the quality measures that are relevant to their practice. These quality measures ultimately help the organization to increase the quality of healthcare services provided to patients.
b) Provider Compliance Training: Provider Compliance Training is a course designed to educate healthcare providers on CMS policies and procedures. It is essential to know and understand these policies and procedures to ensure compliance.
c) CMS Telehealth: This tool allows healthcare organizations to provide healthcare services remotely. It is especially useful during the current COVID-19 pandemic, enabling healthcare organizations to provide quality healthcare services to patients while remaining compliant with CMS policies and procedures.
Conclusion: The CMS has taken an active role in ensuring healthcare organizations provide high-quality healthcare services to patients while maintaining cost-effective practices. Healthcare organizations need to comply with CMS policies and procedures to receive reimbursement fees effectively. We have discussed various tools that can be implemented to ensure compliance with CMS policies and procedures, ultimately achieving the organization’s goals.
