Patient Protections Affordable Care Act
Patient Protections Affordable Care Act
Driven by the long period and extensive voicing about quality of care matters and the desire to contain health care costs, the Patient Protections Affordable Care Act (PPACA) is composed of a number of measures that aim to elevate the quality of medical care as well as bringing to a decline the increase of health care costs (Patient Protection and Affordable Care Act, 2010). With the help of a number of processes like the formation of an innovative payment and delivery form, value-based purchasing projects, quality reporting and formation of a center for Medicare and Medicaid innovation (CMI), the act offers a model a form for rewarding and motivating collaboration, composition, reliability and quality care to be used in a wide range.
Payment Changes
Hospital Value-Based Purchasing Program
This program is composed of a value-based incentive payment that will be offered to hospitals that are in line with the performance levels set by Health and Human Services. The standards will be composed of levels of attainment and advancement (Allen and DeLegge, 2012; Gottlieb, 2012). Additionally, all the hospital will have a method evaluating the performance based on their standards. The secretary of the health and human services will be in charge of managing and coordinating the quality measures by the physicians and other service providers and distributors.
Value-Based Payment Modifier
This will be managed by the physician-fee schedule. The act directs the secretary of health and human services to set up a budget modifier that offers a differential payment to a health worker with regard to quality of care in regard to cost (Allen and DeLegge, 2012). Additionally, the secretary is mandated to set up a relevant, risk-based measure of quality of care offered by the health practitioner so as to estimate the health outcome.
Reporting Requirements
Improvement in the Physician Quality Reporting (PQR)
Incentives will be offered to health workers that report quality data to Medicare using the PQR program. This will not be offered to covered professional processes. The act directs the secretary to come up with a plan that will include reporting with the help of electronic health records (Cannon, 2013). The feedback of the report on performance ought to be on time. Additionally the secretary is supposed to form an informal process for competent experts to acquire a review on matters of unsatisfactory issuance of quality data.
The system offers a quality reporting for long term hospitals, rehabilitation centers, psychiatric hospitals and hospice processes.
Data Collection and Public Reporting
The government looks to acquire quality data and make good use of it as stated in the PPACA. The secretary will be supposed to collect and integrate consistent information on quality and use of resources for the IS applied in issuance of health care. This will apply the public reporting of performance information. The secretary is supposed to make sure that collection, integration and evaluation of the systems are extensive of the patient, practitioners and regions. The secretary will offer grants to maintain quality data acquisition and resource use (Gottlieb, 2012; Patient Protection and Affordable Care Act, 20`0). The act authorizes sums to be appropriate as required for the financial years 2010 to 2014.
Improvements to the Physician Feedback Program
The health practitioner may acquire reports from CMS from Medicare claims payment information. In the Physician Feedback Model, the act tells the Secretary to use claims information so as to offer confidential details to health workers that measure the resources used (Cannon, 2013). The act similarly needs the secretary to offer report to the health workers which compares trends of usage of resources to trends of other health workers. The secretary will have to meet variations in socioeconomic and population attributes and health conditions and to do away with regional changes in payment levels.
New Government Programs
Center for Medicare and Medicaid Innovation
The PPACA forms a new CMI which tests for innovative payment and service allocation so as to limit program expense while maintaining and improving quality to patients (Harrington and Estes, 2012). The CMI will test: use of care deliver models, use of technology-enabled networks to manage patients among others. These models will be assessed in regard to quality, results of patient levels.
National Strategy for Quality Improvement in Health Care
The PPACA mandates the secretary to form a process that will advance health delivery care services, health results and population health (Cannon, 2013). In coming up with this strategy, the secretary will have to note vital deliverables for elevation of health requirements like health care cost, quality and reliability, limitation of contrast and advancement of health results in terms of efficiency.
Quality Measurement
PPACA directs for the formation of a group of several stakeholders so as to offer valuable input to the national needs and choose of quality measures. The secretary has to take into consideration the input that the stakeholders will have in keeping and improving of quality (Gottlieb, 2012; Harrington and Estes, 2012). The secretary will assess the quality measures after three years so as to know the application of these measures or to do away with them. The act directs the use of $20 million from the insurance fund for this operation.
Quality and Safety Education for Nurses (QSEN) Competencies
This competencies looks to meet the issues of getting health workers ready with vital skills and attitudes needed for constant quality improvement and safety where they operate.
Patient-centered care
The quality measures to be implemented by the act are centered on the patient this is in terms of an extensive payment method (ML and Frisby, 2011). The secretary is supposed to come up with models that are based on the assessment of quality and measurement.
Teamwork and collaboration
This is vital in getting everyone on board. The act will have a working group of senior representatives of a number of agencies so as to; collaborate and consult on objectives, do away with duplication and measuring the level of quality results acquired
Evidence-based practice
PPACA directs for the formation of models with clear processes that advance evidence-based patient involvement and medicine as well as aligned national evidence-based guidelines for cancer patients in regard to varied groups.
Quality improvement
The act directs for the use of a clear process that improves the delivery of health care services, health tests results and general population health. There is similarly use of groups that do away with duplication hence quality improvement (ML and Frisby, 2011). The act additionally allows for offering grants so as to help in getting to know and application of models and practices.
Safety
PPACA requires for a study that is composed of an analysis of how legislations may affect the quality of care and safety of the patients. The readmission rates of hospitals ought to be improved with the help of patient safety companies.
Informatics
Information is a vital component in sorer to acquire quality process in health centers. The act directs the secretary to make information available to the public and relevant stakeholders. This information may involve tests, payment, and analysis among others.
References
Allen, J. and DeLegge, M. (2012). Health Care Reform and Gastroenterology, An Issue of Gastrointestinal Endoscopy Clinics. New York: Elsevier Health Sciences.
Cannon, M. (2013). The PPACA’s Health Insurance Exchanges and Medicaid Expansion. Retrieved from: http://www.cato.org/publications/congressional-testimony/ppacas-health-insurance- exchanges-medicaid-expansion.
Gottlieb, S. (2012). Health care consolidation and competition after PPACA. Retrieved from: http://www.aei.org/speech/health/healthcare-reform/ppaca/health-care-consolidation-and- competition-after-ppaca/
Harrington, C. and Estes, C. (2012). Health Policy: Crisis & Reform. Burlington: Jones & Bartlett Publishers.
ML, M. and Frisby, AJ (2011). Multimethod teaching strategies to integrate selected QSEN competencies in a Doctor of Nursing Practice distance education program. Nurs Outlook 59(3):166-73. doi: 10.1016/j.outlook.
Patient Protection and Affordable Care Act, H.R. 3590 (2010). Retrieved from: http://democrats.senate.gov/reform/patient-protection-affordable-care-act-as-passed.pdf .
