How does being transparent assist in bringing about a healthier life? When there are no surprises, no deep voids, or lurking fears of external limitations, the power within one bursts free. It shines continuously, with an enhanced, brighter quality. How does one reach this stage of well-being and control when it comes to their own health? Well, it all begins with medical transparency. All through the healthcare industry, there is a large demand for more transparency, but what exactly does transparency mean? The truth about transparency in health care is that it does not have one true definition. Transparency is just as complex as the health care system itself and may have different meanings to different people. To an individual who may need …show more content…
This is where confusion may take place with some patients. These services should be clearly disclosed to patients in a pure matter prior to any arrangements being made. Such services may include “24-hour-a-day care at home, meals delivered to your home, homemaker services like shopping, cleaning, and laundry when this is the only care you need, and… care given by home health aides like bathing, dressing, and using the bathroom when this is the only care you need” (Centers for Medicare & Medicaid Services 2010). In order to clear up this cloud of confusion for the older American population and their families when it comes to their Medicare coverage, effective transparency and communication needs to take place as soon as the option of home health care is bought up by their primary care physicians. As mentioned in Health Care Delivery in the United States by James R. Knickman and Anthony R. Kovner, most of the decisions about which health care procedures an individual receives is made by primary care physicians (Knickman & Kovner 2015). A solution that can be put into the works is having the primary care physicians spend some time with the patient and break down the plan that they have in store for the individuals’ care. The “Title VI. Transparency and Program Integrity Act” caters to this notion by stating that transparency, “helps patients take more control of their health care …show more content…
Quality is measured as “the degree to which services for an individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” (Knickman & Kovner 2015). An effective tool in the measurement of quality and comparison of home health care agencies is known as Home Health Compare. Home Health Compare is a reliable government tool guide and provides insight about the quality of care provided by different “Medicare-certified” home health agencies per different patient experiences. Quality metrics are a key component of an effective quality management plan in any home health care agency and it is important for future patients to utilize this tool. This tool of comparison allows patients to, “…learn how well home health agencies care for their patients… Shows you how often each agency used best practices when caring for its patients and whether patients improved in certain important areas of care… Shows you what other patients said about their recent home health care experience” (Medicare.gov 2015). The best part of this tool is the fact that the information provided is not based on what the home health care chooses to disclose. It is based on actual patient experiences with the facility and provides truth in regards to the quality of care received during their 60-day episode with the home health care and their
...pital setting and by office managers in a physician office setting, will look at effectiveness- through evidence based data emphasizing on preventing disease and early detection through the use of the right testing. The monitoring will be done using the framework developed by the Agency for Healthcare Research and Quality (AHRQ), which serve “as an indexing system to map the landscape of available measures and measurement gaps for care coordination. The goal of this framework is to start from the top, by achieving care goals through adhering to patient needs and their preferences. Mechanisms vary from communication to creating a proactive plan and they are used to facilitate the goal of care coordination. Overall, this framework serves as a well to assist care coordination. To monitor it, healthcare providers must check off that all of these requirements are met.
Margaret E. O’Kane is the founder and president of the National Committee for Quality Assurance (NCQA). NCQA is one of the nation’s leading advocates for improving healthcare through measurement, reporting, and accountability. NCQA is the foremost accrediting organization for health plans including HMOs, PPOs, and consumer directed plans. (Margaret) “Our goal is to increase the value of NCQA accreditation both to organizations pursuing accreditation and to the audiences who seek help in assessing the quality of health care provided by those organizations”. NCQA has developed, maintained, and expanded the nation’s most widely used health care quality tool, which is known as the Healthcare Effectiveness Data and Information Set (HEDIS). HEDIS is responsible for evaluating whether and how well
It involves the mental, physical, emotional, and medical domains of the individual’s life, but due to the fact that many of these services are publicly funded, gaps exist. Cox (2007) reported that “community resources were generally perceived as inadequate. None of our participants had ready access to social workers in the office, so arranging home health care, adult day care, and other community services added to the difficulty of primary care” (p. 82). Not only are the services and programs inadequate, recent economic dilemmas and ‘recession’ has reduced public spending to meager allowances. Another sore problem is Medicare and general health care programs for the less wealthy. This was the sentiment echoed by one physician interviewed: “If you told me I had to run this place on the basis of what I get from Medicare, I would have to tell you I couldn’t do it, which is kind of sad, because they claim that they’re bankrupt and everything. Where in the hell are they spending their money? They sure ain’t giving it to
In the past few years there has been much debate over the Affordable Care Act and its effects on the healthcare industry in the United States. The Affordable Care Act (ACA) “Will ensure that all Americans have access to quality, affordable health care and will create the transformation within the health care system necessary to contain costs” (The patient protection and affordable care act detailed summary, n.a.). However, what these transformations are and how they will affect the healthcare system, specifically primary care physicians are uncertain. Primary care physicians are the cornerstones for patients in the health care system. They act as a liaison between families and specialist physicians. Primary care physicians provide a variety of patient care services that involve multiple skill sets. They are in charge of diagnosing the patient and managing the plan of care. As a result of the newly implemented Affordable Care Act and the current shortage of primary care physicians “The primary care doctor is a rapidly evolving species -- and in the future could become an endangered one” (Okie, 2012).
The medical Profession recognizes that patients have a number of basic rights. These include but are not limited to the following: the right to reasonable response to his or her requests and need and needs for treatment within the hospital's capacity. The right to considerate, respectful care focused on the patient's individual needs. The right of the patient to make health care decisions, including the right to refuse treatment. The right to formulate advance directives. The right to be provided with information regarding treatment that enables the patient to make treatment decisions that reflect his or her wishes. The right to be provided upon admission to a health care facility with information about the health care provider's policies regarding advance directives, patient rights, and patient complaints. The right to participate in ethical decision making that may arise in the course of treatment. The right to be notified of any medical research or educational projects that may affect the patient's care. The right to privacy and confid...
Taking care of the individuals that are getting older takes many different needs. Most of these needs cannot be given from the help of a family. This causes the need of having to put your love one into a home and causing for the worry of how they will be treated. It is important for the family and also the soon to be client to feel at home in their new environment. This has been an issue with the care being provided for each individual, which has lead to the need of making sure individuals have their own health care plan.
According to Stanford & Connor (2014), as quoted by Hillary Clinton, “In almost every profession-whether it is law or journalism, finance or medicine or academia or running a small business- people rely on confidential communications to do their jobs. We count on the space of trust that confidentiality provides. When someone breaches that trust, we are all worse off for it (p.59).
The debate is still going on today about what can and cannot be done legitimately with patients health information. There are worries about who should be able to access the patient’s information and for what reasons do they have to be accessing the patient’s health information. While on the other side there is an increasing need for performance assessments, efficient health guard, and a proficient administration for more and better information. Health care services are now starting to realize that they have a lot of work to do to be in compliance with the current health laws on the state and federal level guidelines when it comes to dealing with protecting patient data.
The general meaning of transparency implies openness, or see-through, which is then applied to socio-politics with regards to accessing information and governmental records to better enable knowledge sharing and accountability. Finel and Lord (1999) define transparency as legal, political, and institutional structures that make internal information about a government and society available to actors both inside and outside of domestic political systems. According to Ann Florini (1998; 2002; 2008), transparency is the opposite of secrecy and a choice encouraged by changing attitudes about what constitutes appropriate behavior. Gupta (2008) and Mason (2008) further highlight the complex, contested, and important nature of transparency as a tool
Nursing home is a place offers residential care for people who need continual nursing care [1]. In recent years, the number of older Americans over age 65 live in nursing faculties is more than 1.4 million, and it is expected to increase because of the aging of baby boom generation and population ageing. 6% of nation’s healthcare expenditures are spent on 15,500 nursing homes in U.S. The increasing population requiring nursing home and increasing expenditures suggest a pressing need for quality measure in nursing homes.
... is an abstract model that proposes an exploratory plan for health services and evaluating quality of health care. In accordance with the model, information about quality of care can be obtained from three categories: structure, process, and outcomes. In addition, not long ago The Joint Commission include outcomes in its accreditation valuations (Sultz, & Young, 2011, p. 378).
The public agencies such as CMS have periodically made drastic changes to their reimbursement policies. In 2003, the CMS began the hospital quality initiative and Home Health quality Initiatives ( Denisco & Barker, 2013). The hospital quality initiative mainly focused on Acute Myocardial Infarction (AMI), heart failure ( HF), and pneumonia( PNE). The home health quality initiatives also focused on quality measures for individuals receiving home care services ( DeNisco & Barker, 2013). In 2001 about 3.5 million disabled and elderly Americans received care from 7,000 Medicare certified home health agencies and about 3 Million elderly and disabled Americans received care from 17,000 Medicare and Medicaid certified Nursing Homes ( DeNisco & Barker, 2013). In 2004, CMS Nursing home Quality Initiative started 14 quality measures in the areas of delirium, pain( acute and chronic), incontinence, decline in activities of daily living, physical restraints, worsening of anxiety and depression, pressure sores, indwelling catheters, mobility decline, bedfast, weight loss and urinary tract infections( DeNisco & Barker, 2013). The National...
Health care must be fully accountable for quality and the patient experience is simply the patient's perception of quality. Society should question and debate on how healthcare organizations should show improvement for consumers. This can help organizations create reliable health coverage cost and evaluate medical performances for families and individuals in the future. Physicians and organizations are now evaluating patients with collection of electronic data to improve a patient’s...
Medicare is the federal program that provides health coverage for people who are 65 and older (Green, 2003). Although many assume that Medicare provides long-term care, these benefits are very limited and are not efficient enough to accommodate the much needed care services for older adults. For example, Medicare programs do not help to pay for personal care services such as eating, dressing or using the bathroom even though these “activities of daily life” are the most needed services for most seniors (Green, 2003). These care services can be provided to seniors by the long term care insurance program. According to the national survey that was conducted among people who are 55 and older, just 36% believed that they would need long term insurance (Carter, 2008). However, it's estimated that at least 60% of people over age of 65 will require some long-term care services at...
This study is intended to further understand the impact of health care quality and cost