...| Implications of Regulation in Health Care | Week 5 Application | | Tiffany Littlejohn | 2/9/2014 | | Implications of Regulation in Health Care In today’s highly competitive regulated healthcare environment, it is so important for different companies to bring to their market new medical technology and to keep them in their market. Therefore, managing different regulatory issues is an essential key to a strategic advantage. Currently, there are strong standards and guidelines put into place to ensure that all devices are well safety equipped, well studied before putting it out in the market and have less negative reactions. The strongest way to judge efficacy of any technology is data acquisition through randomized clinical trials (Berkowitz, Robert, 2010). Off course, this is not possible or even feasible in certain cases. Properly designed case series and cohort studies can provide and prove hypothesis. Observational and epidemiological studies can help identify unexpected deviations and outcomes. Meta-analysis can then take in to consideration all the available evidence and summarize the current state of knowledge. Incorporation of Cost-Effectiveness Analysis and Cost-Benefit Analysis help calculate and extrapolate economic aspects of any medical technology. Technology continues to affect the healthcare industry (Berkowitz, Robert, 2010). Currently, the industry is moving towards the electronic medical record (EMR), data reporting from the EMR, and...
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...March 2, 2012 FINAL PROJECT 8 The most critical issue the U.S is facing is The Federal regulatory expenses. U.S. is on the path for a deficit of 1.5 trillion or more in the future. The funding reduction that should be cut out is the Federal regulatory expenses, Federal spending US cut; it could raise the economy backup and help the US out of debt. The Federal spending has developed out of proportion and is growing and not reducing the deficit. Some people believe that part of this careless budget is due to regulatory efforts. By cutting this funding tax payers and the economy could be building back up. Even President Obama’s acknowledgement about the extra federal regulations had subdued innovation which had a disturbing outcome on growth and jobs. New public companies in the United States, capital business, and entrepreneurship have all been affected by the result of federal regulations. Some people believe that part of this irresponsible budget is allocated to regulatory efforts. By reading the research and report my criteria would be for renewed economic growth to reduce regulations, so businesses are free and motivated to expand and update. By cutting agency budgets the Federal budget would not only be reduced, but it would have the added benefit of lowering the overall budget. All businesses should get a chance to start or update their businesses with an overall success rating. The second most critical issue the US is facing is the flow immigration. There...
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...Health Law and Regulations Crystal Sullivan HCS/545 October 6, 2014 Terry Matherne Health Law and Regulations According to "About Hhs" (2014), the purpose of governmental regulatory agencies in healthcare is “for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves” (para. 1). Governmental regulatory agencies have taken on the problems of both consumers and health care providers in an attempt to find solutions that will meet everyone’s needs. They take their ideas and the ideas of the public, and create rules and regulations for the healthcare industry. Regulation plays a critical part in the healthcare industry. The U.S. HHS (the Department of Health and Human Services) has developed several public health regulations to protect the citizens of the United States. The job of the HHS to determine which laws and regulations will be in the best interest of the public. “Through various regulatory bodies, the Department of Health and Human Services (HHS) protects the public from a number of health risks and provides programs for public health and welfare. Together, these regulatory agencies protect and regulate public health at every level” ("Healthcare Regulation", 2014). The government uses federal regulations to implement public policies. The federal government healthcare agencies are allowed to issue rules during the rulemaking process with the approval of congress. There are several...
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...ABSTRACT The benefit of a Health Information Exchange (HIE) is facilitation of access to and retrieval of patient healthcare through safe, timely, efficient, effective, equitable, and patient centered methods. Sustainable HIE in the United States requires bringing several key ingredients together in order to create a service that will remain an invaluable part of health care culture and delivery. According to research, achieving sustainable HIE in the U.S. is creating a reality in which: (1) it is feasible for any health care provider, consumer or payer to electronically share individually identifiable data supporting efficiency and quality of care in a standards-based format through non-proprietary mechanisms using an approach that adheres to all federal security and privacy laws, regulations, and policies, including those of state governments; and (2) the costs and benefits of HIE are arranged so after establishment, HIE will be funded through mechanisms that reflect the collective advantages of HIE, such as third party reimbursements, instead of through extraordinary sources (NORC, 2009). The most notable challenges to achieving sustainable HIE include lack of financial incentives for using HIE, circumstances where those benefiting from HIE are not always those bearing the costs, and the lack of a consensus on a solid blueprint for building a successful and sustainable HIE. Currently, however, state governments are key players in health information exchange through; their...
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...Changes in the Health Care System and the Practice of Nursing have become complex. Technological changes, complicated client needs, short hospital length of stay, and departure from acute care to community based care, all these changes have underscore the need for professional nurses to think critically in order to provide safe and effective client care. A better educated nursing workforce can provide good health education to patients and their families. The affordable care of 2010 has required the need for nurses to expand their role of practice to meet complicated patient demands. This has prompted the Institute Of Medicine to review the “Future of Nursing, Leading change and Advancing Health”. {Creasia & Fribery,2011} The Impact of the IOM report on Nursing Education. According to IOM report the future of nursing is aimed at improving the health of Americans by transforming the nursing profession. It is important for nurses to receive higher education and training to meet the dynamic environment in which they will practice.{Institute of Medicine,2010}. The IOM recommends that 80% of the nursing workforce will have baccalaureate degree in nursing by the year 2020. These nurses would be able to promote quality of nursing care through their critical thinking skills and research. Nurses should achieve higher levels of education and training through an improved education system by encouraging associate degree nurses to obtain BSN degrees. A highly educated nurse is preferred...
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...Ambulatory Surgery Centers: A critical regulatory issue Ambulatory surgery centers are considered medical facilities that are specifically designed to give elective same-day surgeries to ease the high traffic at local hospitals. They do not offer emergency care in this type of facility because it is not considered a hospital. This type of facility means that a patient does not have to be admitted to a hospital and will go home after the procedure is finished. There are many legal issues regarding these types of facilities, and as you will read, they have to do with physician ownership, out of network waivers, and Medicare cases. It takes a lot of effort to run a surgical center and to find out what kind of legal issues can be involved with this type of center. One of the main sources of legal debates that are prevalent in ambulatory surgery centers is when new owners are trying to “buy-out” an owner that is leaving the business. A lot of centers grapple with the understanding of their present contracts concerning buying and with the legal obligation of selling the center for retail value. When a surgery center needs to sell because of finances, the ability to find someone who will give a fair market price can be difficult. Watching and assessing which new owners that will enhance the productivity of the center. Another great debate that involves physician ownership is the newly revised coverage rules and regulations which is a necessity for the early notice of physician...
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...Regulatory Health Issue: Affordable Care Act Regulations There are many, critical regulatory issues in healthcare that need to be addressed. “While the Supreme Court weighs the constitutionality of the Affordable Care Act, Congress is holding hearings on the federal regulatory process. The two topics are more closely related than you might think” (Ellig). The one that jumps out to me and needs addressed more in-depth is the regulation of the payments for healthcare. As well as, the actual regulatory process and how certain sections of the healthcare system are picked, need to be regulated. Not only is the regulation of this part of the healthcare system have many issues but in general choosing what to regulate and the actual process of research needs looked into. Regulating parts of the healthcare system is done to ensure that healthcare facilities, and businesses, laws, and acts are properly dealt out. There needs to be rules for laws, so that everyone is treated fairly and equally. The article explains that there was not enough research done to require new or improved regulatory requirements. The Affordable care act was put in place by President Barrack Obama to ensure that all Americans have the ability to purchase insurance for themselves and their families. It was put into play to see that it was affordable and did not discriminate against age, race, sex, and illness. Some of the regulations made were ensuring that insurance companies could not deny coverage to someone...
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...Facility Planning Part 2 Pamela Jackson HCS/446 September 28, 2015 Rachel Rivera Facility Planning – Part II Facility planning for a health care organization or outpatient clinic takes on its own unique regulatory requirements. Regulatory requirements are requirements that have been mandated by various federal, states, and local municipalities regarding the operation and safety of business operations as well as services provided. They are the legal fence between education and catastrophe.”The basic regulatory frameworks and acts that govern the present business operations include Sarbanes Oxley Act ([SOX], 2002), Gramm-Leach-Bliley Act (1999), and Health Insurance Portability and Accountability Act ([HIPAA], 1996).” (Ezinearticles.com 2012) The main purpose of these regulatory requirements and tools is to ensure that society as a whole reap the benefits through accountability, integrity and confidentiality. The impact on regulatory requirements is based on how they are implemented. Regulatory Requirements Effect on the Design and Equipment Many times when planning a facility for use in an outpatient clinic it is important to research the regulatory requirements for equipment utilized in the care of patients and how it will impact the over all care, safety and wellness of the organization. The design of health care facilities is governed by many regulations and technical requirements. It is also affected by many less defined needs and pressures. The facility must...
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...According to the American Telemedicine Association, the relatively new remote medicine field has grown into a multi-billion dollar industry. Most home health agencies, hospitals, primary care providers, and specialists utilize some form of telehealth technology, while continue to strive toward building a legal foundation. Health care organizations and insurers view telemedicine as a welcome alternative to time-consuming and costly office visits, and consumers increasingly accept telemedicine as a norm. Furthermore, the technology allows consumers to connect with providers conveniently using such as mobile phones and tablets. However, telemedicine practitioners currently rely on laws design for traditional settings. The following topics review a few of the concerns affecting telemedicine providers. Patient Privacy and Confidentiality With telemedicine, care providers can store...
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...ULTRASOUND TRANSMISSION AND NETWORKING SYSTEM IN A HOSPITAL NAME: INSTITUTION: Introduction Ultrasound is sound frequencies waves with which are normally higher than those audible to human beings; Ultrasound is used in navigational, electronic, industrial, and also security applications. It is also used in medicine to view internal part/organs of the body of a human being such as muscles, joints, tendons, vessels and internal organs. Its aim is often to exclude any pathology or to find a source of a disease. The practice of examining pregnant women using ultrasound is called obstetric ultrasound and is widely used. Ultrasound machines will differ basing on the features that they mainly offer, (Dion, et al 2002) . The features may comprise freezing an image, image storage, standby mode in saving battery power and ergonomic design, and also water and dust resistance, even oil resistance. There will also be a variety of weights and sizes, ease of use, workflow, durability and service. In the hospital setup, transmitting ultrasound images from the ICU to the main hospital, the outpatient and other relevant hospital departments will entirely depend on the size of the hospital/clinic, some technicians, quality, and versatility of images and videos and storage expected. High-quality ultrasound machines will, therefore, give quality images, videos and any scanned document hence making easing the work and offering quality services while meeting the hospital goals. It is, therefore,...
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...ULTRASOUND TRANSMISSION AND NETWORKING SYSTEM IN A HOSPITAL NAME: INSTITUTION: Introduction Ultrasound is sound frequencies waves with which are normally higher than those audible to human beings; Ultrasound is used in navigational, electronic, industrial, and also security applications. It is also used in medicine to view internal part/organs of the body of a human being such as muscles, joints, tendons, vessels and internal organs. Its aim is often to exclude any pathology or to find a source of a disease. The practice of examining pregnant women using ultrasound is called obstetric ultrasound and is widely used. Ultrasound machines will differ basing on the features that they mainly offer, (Dion, et al 2002) . The features may comprise freezing an image, image storage, standby mode in saving battery power and ergonomic design, and also water and dust resistance, even oil resistance. There will also be a variety of weights and sizes, ease of use, workflow, durability and service. In the hospital setup, transmitting ultrasound images from the ICU to the main hospital, the outpatient and other relevant hospital departments will entirely depend on the size of the hospital/clinic, some technicians, quality, and versatility of images and videos and storage expected. High-quality ultrasound machines will, therefore, give quality images, videos and any scanned document hence making easing the work and offering quality services while meeting the hospital goals. It is, therefore,...
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...Nursing shortage is featured in every magazine, health articles, newspaper, television and other forms of communications. Nursing shortage creates serious concerns not only in the field of medicine but in the consumer’s eyes. Health is considered a basic need of mankind; therefore, everyone is affected in maintaining the health status. Nurses are a major workforce in the provision of health care. Where does this discussion lead? Is there a serious threat? What happens now? Is it global? All these questions pump adrenaline to everyone who is concern about their health status. Health care organizations, specifically hospitals have significantly felt the impact of nursing shortage. Nurses are an integral part of any health care organization; and are known to the health care community as front line workers. The following outline is to discuss a health care situation such as nursing shortage in hospital settings. This outline is to provide a comprehensive overview by analyzing and evaluating the effectiveness of procedures that are in place, and recommend improvement strategies based on economic theories and concepts that support best practices. Key Players Nursing shortage is a work in itself, there is no immediate solution to the problem; therefore, nurses as the key players must be involved in the decision making occurring at every health care organization. As nurses, the sole responsibility lies upon them to establish a safe working environment, ensuring patients and nurses’...
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...Health Care Law, Regulations and Policy HCS/545 November 23, 2015 Health Care Law, Regulations and Policy Health Care law and legislation came about to define the scope of acceptable practice of clinicians, while protecting the public’s individual rights. Miller and Hutton states “Law can be defined as a system of principles and processes by which people who live in a society attempt to control human conduct to minimize the use of force in resolving conflicting interests.” When creating laws, conflicting interest often takes into consideration the basis ethical principles that includes autonomy, beneficence, nonmaleficence, and justice to name a few. Laws, particularly health care laws are often in the form of a statutes, such as the nurse practice act, that serves as a guidance for nurses to know what defines and limits our practice. As such, the law also regulates how statures must be enforced. Administrative agencies, such as the Center for Medicaid and Medicare Services under the auspices of the Health and Human Services, have created rules and regulations to enforce statutory laws. When we look at laws in nursing and other industries, it is an extension to address ethical issues that universally affects our society. Health care agencies are mandated to adhere to the rules that are created by regulatory agencies that can come in the form of laws, regulations, or codes, and are enforced through controls that make sure that these rules are adhered...
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...Performance Standards November 24, 2014 Dr. Debbie Simmons Quality Improvement Email Health care organizations aim to provide both quality and safe patient care. These two fundamental and critical concepts in health care require continuous effort. “Organizations must make an intentional effort to measure, assess, and improve performance” (Spath, 2014, pp.266). Quality improvement (QI) is essential for the continued success of an organization as it reveals specific guidelines and methods to provide consistent and dependable quality services. This paper will discuss QI while focusing on quality management’s role and importance in health care, stakeholder’s different views of quality, QI roles, and what areas in health care require monitoring. Additionally, involved accrediting and regulatory organizations in QI and helpful resources and organizations that affect QI will be discussed. Quality Management According to Kelly (2011), quality management refers to how managers operating in various types of health services organizations and settings understand, explain, and continuously improve their organizations to allow them to deliver quality and safe patient care, promote quality patient and organizational outcomes, and improve health in their communities” (pp. 9). Therefore, the purpose of quality management is to enhance the effectiveness, efficiency, and safety of health care processes to achieve quality outcomes. Management can achieve this through providing effective...
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...Article or Case Law Search Article or Case Law Search There are many cases that address the current critical regulatory issues in health care. Medicare fraud and abuse violations are only but one critical regulatory issue that is happening in America today. Medicare fraud and abuse is a major issue and it must be addressed. Many people today are lying on their applications in order to be approved for Medicare. This is hurting the people who truly need Medicare. Nature of Medicare fraud and abuse laws Medicare fraud and abuse is when someone will make false statements about themselves or that someone else is giving false information so the other person can get Medicare. When Medicare fraud happens it can either be a one person act or from a group of people or even an organization. Many people around commit fraud, in fact you may know someone who has already done so or may do so. “Organized crime is infiltrating the Medicare Program and masquerading as Medicare providers and suppliers” (Department of Health and Human Services, 2012). Some forms of Medicare fraud are: When someone is billing for services but there were no supplies that were available or services, when someone has billed Medicare for appointments that weren’t made, when someone changes claim forms or makes changes to receipts in order to get higher payments. Medicare abuse is when there is unnecessary cost in Medicare. “Abuse includes any practice that is not consistent with the goals...
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