how does medicare certs affect healthcare
COMPETENCIES
7022.1.3 :
Licensure, Certification, and Accreditation Standards
The graduate analyzes how licensing, certification, and accreditation agencies for healthcare organizations impact healthcare delivery at federal, state, local, and organizational levels.
7022.1.4 :
Quality, Reimbursement, and Patient Access to Healthcare
The graduate analyzes how relationships between clinical healthcare quality, reimbursement for services, and patient access to medical care influence the services that are provided at various levels of healthcare organizations.
7022.1.5 :
Federal Healthcare Legislation and Programs
The graduate analyzes how federal legislation and programs influence the provision of services at all levels of healthcare organizations.
INTRODUCTION
The healthcare ecosystem is influenced by external forces in the form of government regulations, accreditation standards, and federal legislation. These regulations and this legislation are components of federal government programs and bring with them directives that may affect the economics of healthcare. As greater numbers of healthcare organizations implement information systems across the United States, a seamless exchange of health information may provide consumers with a higher quality of care, improvement in patient access, and more efficient control of the cost of healthcare services. The healthcare ecosystem is one of continuous change, and health information management is supporting many of the changes.
REQUIREMENTS
Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. The similarity report that is provided when you submit your task can be used as a guide.
You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.
Tasks may
not be submitted as cloud links, such as links to Google Docs, Google Slides, OneDrive, etc., unless specified in the task requirements. All other submissions must be file types that are uploaded and submitted as attachments (e.g., .docx, .pdf, .ppt).
A. Discuss how Medicare certification affects healthcare delivery based on the Conditions of Participation.
1. Explain the difference between accreditation and licensing for healthcare organizations.
B. Explain the relationship between a quality reporting system and reimbursement for healthcare services (e.g., Merit-Based Incentive Payment System and value-based care).
1. Discuss how patient Medicare eligibility requirements influence the types of healthcare services available to patients.
C. Discuss
one example of federal legislation that affects the provision of healthcare services.
D. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.
E. Demonstrate professional communication in the content and presentation of your submission.
