Differentiating Roles And Main Activities Of CMS And Joint Commission

HCPCS codes facilitate the procedure of processing health insurance claims made by insurers such as Medicaid. The HCPCS is divided into two levels or classes. The task of classification lies with the Centres of Medicaid and Medicare Services (CMS) in association with the HCPCS work group and other third party payers. Classification is done quarterly, marking a significant step-up from its previous system of annual updates. Since 2014, the CMS has been implementing several changes regarding the continuation of HCSPCS level II.

Impact of CMS Regulations and Reimbursement Models The Health Care Industry HCM307-1802B-03 Unit 1- Individual Project 1 Michael Green May 22, 2018 Introduction Healing Hands Hospital is preparing financially for the many different reimbursement changes associated with Medicare Advantage Plans. My financial team and I, have been asked to evaluate our current billing and operations workflow processes and incorporate the current trends. We will be discussing how Medicare Advantage affects Healing Hands Hospital, and how we can utilize these trends to maximize patient care. Organizational Budget Reimbursement and financial trends will change go hand and hand.

The author is highly motivated to address the ongoing changes in

Thank you for your all information. Your answer is very organized and well addressed the question. I agreed with you the Joint Commission's mission and goal now is to focus on continuously improving health care for the public by evaluating health care organizations and inspiring them to excel in providing the safest and effective care of the highest quality and value. According to the Joint Commision (JC), there are no new National Patient Safety Goals in 2015, but JC continuously determines the highest priority patient safety issues and how best to address them. For exxample, for hospital setting, the goals focus on following problems: identify patients correctly, improve staff communication, use alarms safely, prevent infection, identify

Their mission is “to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value”, (Joint Commission, 2014). The accreditation from the Joint Commission can be earned by multiple health care organizations including critical access hospitals, office based surgery centers, behavioral health care facilities, and home care services. For a hospital setting, the Joint Commission places the performance measures into accountability and non-accountability measures. They look at research and if the facility is performing evidence-based care process which improves health outcomes, proximity which the care process is linked to the patient outcomes, accuracy for whether or not the care process has indeed been provided, and any adverse effects. To earn and maintain The Joint Commission’s Gold Seal of Approval™, an organization must undergo an on-site survey by a Joint Commission survey team at least every three years (Joint Commission,

Joint Commission The Joint Commission is an independent, not-for-profit group in the United States that administers voluntary accreditation programs for hospitals and other healthcare organizations (for example, long term care, mental health, and ambulatory care). The commission develops performance standards that address crucial elements of operation, such as patient care, medication safety, and infection control and consumer rights. According to Rouse M. (2015), the Joint Commission standards function as the foundation for healthcare organizations to measure and improve their performance. These standards focus on quality care and patient safety.

Within the general environment category, the political and legal factors such as the health related legislature influence QSSI’s ability to elevate its position in the Health IT industry marketplace. In 2010, the Affordable Health Care legislation, which includes the Patient Protection and Affordable Care Act in addition to the Health Care and Education Reconciliation Act were enacted. The significance of these pieces of legislation is the fact that collectively they provide an opportunity for millions of low-income and unemployed Americans to gain access to medical care (Affordable Care Act, n.d.). Over the last five years, a government agency, the Centers for Medicare and Medicaid Services (CMS), has been charged with making access to affordable health care its

1. CJCS fulfills the role of principal military adviser in the National Security Council system. The CJCS is the senior most military advisor to the President and in such provides that guidance directly to the President, and by participating in National Security Council Principals meetings in person. During these meetings he provides his best professional military advice to the President and the other cabinet members of the NSC. Additionally, he will send his senior most policy advisor the Joint Staff J5 to sit in on Deputies committee meetings and give his guidance at this next level down.

HSE- Health and Safety Executive • It is the body responsible for the encouragement, regulation and enforcement of workplace health, safety and welfare. • It exists as an independent regulatory act and is in the public interest to reduce work related death serious injury across Britain’s workplace. • Effects all employed in Britain from major injuries. •

Its Oversight Agency According to Law The U. S. Department of Health & Human Services is the government agency that oversees the effective implementation of the Affordable Care Act that is aimed to enhance and protect the health and well-being of all Americans. Inclusive of this objective is also to foster the advancement of medicine, public health, and social services (Health & Human Services, 2015). It has 11 operating divisions, with eight agencies in the U. S. Public Health Service and three human services agencies. They operate a variety of health and human services that are geared towards conducting researches on saving lives of people for the good of the nation.

Healthcare Reimbursement Healthcare is made up of many factors. Among those factors are provider reimbursement and the different types of financial methods used by the patients to acquire healthcare services. Provider reimbursement is important and necessary in order to maintain the continuation of healthcare. Like every organization, including non-profit organizations, require revenue in order to pay their healthcare providers, expenses accrued, and to obtain the supplies needed to aid in rendering services. With that said, this is why there are many financial methods such as third-party payers, government agencies, private health insurance, and patient payments.

A Medicare Severity-Diagnosis Related Group (MS-DRG) is a system of sorting a Medicare patient’s hospital stay into many groups in order to expedite payment of services for Medicare patients (CMS, "Acute Inpatient PPS") . The MS-DRG is the most-widely used system today as a result of the rising number of Medicare patients. Payments are calculated using wage variants, geographic locations, and the percentage of Medicare patients that a hospital treats (CMS, "Acute Inpatient PPS"). In short, the Medicare Severity-Diagnosis Related Group (MS-DRG) system enables the Centers for Medicare and Medicaid Services (CMS) to provide improved reimbursements to hospitals serving more severely ill patients. Hospitals treating less severely ill patients will receive less reimbursement.

8. Why is it important that the regulations of the HCPC should be independently controlled? It is important because HCPC can maintain their quality in regulating health professionals and prevent any influence from the outside, other regulators have to monitor other professionals therefore mixing up their policies and the policies of HCPC could lead to confusion and hence certain professions won’t be monitored as well as they should have

Change management in reducing the percentage of inpatient fall in hospital. Fall is defined as being “an event which results in a person coming to rest inadvertently on the ground or floor or other lower level” (World Health Organization, 2012). The author is a registered nurse working in a private hospital. In the author practicing hospital, inpatient fall was identified has a major problem. The targeted aim for inpatient fall is less than 5%.

Their role is to register care providers, monitor, inspect and rate healthcare services. The CQC has a role in publishing views of the major quality issues and performance ratings to enable consumers to choose care in health and social care. The Commission ensures the quality and safety of care in hospitals, dentists, ambulances etc. The CQC is sponsored by the Department of Health. Governance, Accountability and Staff