Standards
In order for a hospital to be eligible for reimbursement through Medicare, they have to show that they are compliant by way of the Conditions of Participation. One way to show this is by getting an accreditation through The Joint Commission who meets the Medicare Condition of Participation standards. (La Tour, 2013).
Clinical Quality Medical professional should select quality measures for reporting such as commonly treated conditions, the types of care that are frequently delivered, the settings in which care is given, quality improvement goals and other quality reporting options that are available or being considered. A couple of options available are Physician Quality Reporting System and Value Based Purchasing. Both programs are based on quality of care rather than the amount of services they may provide. (CMS, 2014)
Reimbursement for Healthcare Services
Currently Medicare’s reimbursement for service is by the Prospective Payment System. This system is based on a fixed amount for the service provided and also based on the classification of where the service was provided as well. For example, Medicare will provide payment for both the operating and capital-related costs of the acute care hospital as well as the long-term care hospitals. (CMS, 2014).
Patient Access to Care When everyone works together to coordinate the patient care, the patient receives better quality care and everyone will see a decrease in costs. Here are just a few options available that could help patients with access to care. Partnership for Patients hopefully will help to reduce the amount of hospital-acquired conditions and help improve the transitions in the care received. Bundled Payments for Care Improvement will seek to improve the patient care by allowing more flexibility in selecting the types of conditions to bundle for the provider, developing the health