Health Care Quality Evolution Milestone Events Chart

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Health Care Quality Evolution Milestone Events Chart

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Health Care Quality Evolution Milestone Events Chart

Healthcare Legislation, Regulatory Agencies, and Quality Initiatives Milestone Description
1)     1791 Regulating Healthcare States were given the right to regulate health and formally began licensing physicians (Chaudhry, 2010). Health Care Quality Evolution Milestone Events Chart
2)     1800 State medical boards State medical boards license, discipline, and regulate physicians and other health care professionals to protect the public (Truex, 2014).
3)     1850 First health insurance policy The Franklin Health Assurance Company of Massachusetts was the first commercial insurance company in the U.S. to provide private health care coverage benefits for injuries not resulting in death (Scofea, 1994).
4)     1862 U.S. Army Medical Department and the United States Sanitary Commission formed Post-Civil War, new health-related agencies, hospitals, and medical research and care implemented to care for the post-Civil War injured and increase population health awareness (Reilly, 2016).
5)     1886 U.S. Army established the Hospital Corps The first U.S. data repository to collect medical data. This was implemented by the Surgeon General’s Office and the Library of the Surgeon General (Weedn, 2020).
6)     1900 Self-pay is the primary source of payment for healthcare services Most Americans continued to pay their own health care expenses, which often meant either uncompensated charity care or no care. Hospitals were voluntary institutions that were privately supported (University of Pennsylvania School of Nursing, n.d.).
7)     1908 Workers’ compensation legislation President Theodore Roosevelt signed legislation to provide workers’ compensation (WC) for certain federal employees in unusually hazardous jobs (U.S. Department of Labor, n.d.).
8)     1915 American Association of Labor Legislation (AALL) The first universal access health insurance legislation. It would provide limited insurance benefits to working class, their dependents, and others who earned less than $1,200 a year. Although supported by the American Medical Association (AMA), it was never passed into law (Derickson, 2002).
9)     1916 The Federal Employees’ Compensation Act (FECA) Replaced the 1908 WC legislation to include civilian employees of the federal government. They were provided medical care, survivors’ benefits, and compensation for lost wages under FECA (U.S. Department of Labor, n.d.).
10)  1920 Introduction of prepaid health plans (direct contracting) Direct contracting between employers, local hospitals, and physicians for medical services was the first predetermined fee that was paid monthly or yearly basis. These prepaid health plans were the precursor of today’s managed care plans and capitation payments (Young & Kroth, 2018).
11)  1921 -1976 Indian Health Services (IHS) The Snyder Act of 1921 and the Indian Health Care Improvement Act (IHCIA) of 1976 created the legislative authority for Congress to provide funding to Native Americans for health care services, which is now known as the Indian Health Services (IHS) (Warne & Frizzell, 2014).
12)  1921 Sheppard-Towner Maternity and Infancy Act Legislation to reduce maternal and infant mortality. The Act was challenged and then said to be unconstitutional by the Supreme Court. Additionally, the Act was opposed by the American Medical Association. The act was not renewed and expired in 1929. (Moehling & Thomasson, 2012).
13)  1927 Workers’ Compensation Act Office of Workers’ Compensation Programs (OWCP) administers FECA as well as the Longshore and Harbor Workers’ Compensation Act of 1927 and the Black Lung Benefits Reform Act of 1977 (Young & Kroth, 2018).
14)  1929 Blue Cross (BC) Insurance Policy Baylor University, Dallas, TX, guaranteed schoolteachers 21 days of hospital care for $6 a year. Other groups of employees in Dallas joined, and in a short time period BC becomes hospital insurance nationwide (Young & Kroth, 2018).
15)  1930 Blue Shield (BS) Plans Blue Shield (BS) was founded to provide insurance to lumber and mining camps of the Pacific Northwest at the turn of the century. Employers paid fees to medical service bureaus, which were composed of groups of physicians. BS becomes physician insurance nationwide (Young & Kroth, 2018).
16)  1938 The Food, Drug, and Cosmetic Act was signed by President Franklin Delano Roosevelt Food, drug, and cosmetic safety implemented. The new law brought cosmetics and medical devices under control, and it required that drugs should be labeled with adequate directions for safe use (Young & Kroth, 2018; FDA, n.d.).
17)  1939 Wagner National Health Act (S.1620) The bill would have allowed the states to implement mandatory and universal health care but did not pass due to WWII (United States national health program: Wagner, bill, S. 1620, 1939).
18)  1946 Hill-Burton Act Provided federal grants for modernizing hospitals during the Great Depression and WWII (1929-1945). In return for federal funds, hospitals were required to provide services free or at reduced rates to patients unable to pay for care (Young & Kroth, 2018).
19)  1947 Taft-Hartley Act Amended the National Labor Relations Act of 1932, restoring a more balanced relationship between labor and management. An indirect result of Taft-Hartley was the creation of third-party administrators (TPAs), which administer health care plans and process claims, thus serving as a system of checks and balances for labor and management (Achermann, 2009).
20)  1948 International Classification of Disease (ICD), World Health Organization (WHO). Classification system used to collect diagnoses for statistical purposes. Originally used for mortality reporting but later and today used for morbidity reporting as well (Young & Kroth, 2018).
21)  1950 Major medical insurance Birth of the major medical insurance for catastrophic and prolonged illness, with deductibles and lifetime maximum benefit amounts (Young & Kroth, 2018).
22)  1951 The Joint Commission (JC): Facility Accreditation The Joint Commission does accreditation for hospitals and other medical facilities to ensure the facilities pass CMS, state and other inspections and ensure that services and facilities are safe and effective care of the highest quality and value (Young & Kroth, 2018).
23)  1956 Dependents’ Medical Care Act The Dependents’ Medical Care Act of 1956 was signed into law and provided health care to dependents of active military personnel (precursor to CHAMPVA 1973 and now TriCare 1988) (Young & Kroth, 2018).
24)  1966 Social Security Amendments of 1965 Medicare-Title XVIII insurance for Americans over the age of sixty-five (65). Medicaid-Title XIX a cost-sharing program between the federal and state governments to provide health care services to low-income Americans (Young & Kroth, 2018).
25)  1966 Current Procedural Terminology (CPT) The Current Procedural Terminology (CPT) codes were developed by the AMA in 1966 as a way to describe and track physician and other professional medical services. The CPT Code book is updated annually, and changes go into effect on January 1 of each new year (Dotson, 2013).
26)  1970 Controlled Substances Act (CSA); Drug Enforcement Agency (DEA): Controlled substances Controlled Substances Act (CSA) was created to improve the manufacturing, importation and exportation, distribution, and dispensing of controlled substances. Manufacturers, distributors, and dispensers of controlled substances must be registered with the Drug Enforcement Administration (DEA) (Gabay, 2013).
27)  1970 Occupational Safety and Health Administration Act OSHA) The Occupational Safety and Health Administration Act (OSHA) was designed to protect all employees against injuries from occupational hazards in the workplace (Young & Kroth, 2018).
28)  1972 Professional Standards Review Organizations (PSROs) Created as part of Title XI of the Social Security Amendments Act of 1972 were Professional Standards Review Organizations (PSROs), which were physician-controlled nonprofit organizations that contracted with CMS to provide for the review of hospital inpatient resource utilization, quality of care, and medical necessity. The PSROs were replaced with Peer Review Organizations (PROs), as a result of the Tax Equity and Fiscal Responsibility Act of 1982, or TEFRA (Young & Kroth, 2018).
29)  1973 Health Maintenance Organization Act The Health Maintenance Organization Assistance Act of 1973 authorized federal grants and loans to private organizations that wished to develop health maintenance organizations (HMOs), which are responsible for providing health care services to subscribers in a given geographic area for a fixed fee (Young & Kroth, 2018).
30)  1974 Employee Retirement Income Security Act of 1974 (ERISA) ERISA is a federal law that sets minimum standards for most voluntarily established retirement and health plans in private industry to provide protection for individuals in these plans. This law allows employers to be self-insured (Young & Kroth, 2018).
31)  1975 U.S. Nuclear Regulatory Commission (NRC) The NRC is a federal agency that ensures safe use of radioactive materials. They license and regulate the nation’s civilian use of radioactive materials to provide reasonable assurance of adequate safety for people and the environment. In health care this would include all diagnostic medical use, therapeutic medical use, and medical research use (United States Nuclear Regulatory Commission, 2020).
32)  1976 Food and Drug Administration (F.D.A.): Medical Equipment   FDA: Medical Device Amendments passed to ensure safety and effectiveness of medical devices, including diagnostic products (FDA, n.d.).
33)  1977 Health Care Financing Administration (HCFA) The DHHS combine health care financing and quality assurance programs into one agency, HCFA. Medicare and Medicaid programs were transferred to HCFA, which is now CMS (Young & Kroth, 2018).
34)  1980 American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF)             The AAAASF was established to standardize and improve the quality of health care in outpatient facilities. AAAASF accredits thousands of facilities worldwide including clinics, surgery centers, and state/federal health agencies, and patients acknowledge that AAAASF sets the “Gold Standard in Accreditation” (American Association for Accreditation of Ambulatory Surgery Facilities, n.d.).
35)  1980 Department of Health and Human Services (DHHS) The Office of Education and the Department of Health, Education and Welfare (HEW) became the Department of Health and Human Services (DHHS) (U.S. Department of Health & Human Services, n.d.).
36)  1981 Omnibus Budget Reconciliation Act (OBRA) The OBRA was federal legislation that expanded the Medicare and Medicaid programs. Government became more involved in nursing homes, including restraint restrictions (Svahn, 1981).
37)  1982 BCBS Association The Blue Cross Association and the National Association of Blue Shield merge to create the BlueCross BlueShield Association (BCBSA) (Young & Kroth, 2018).
38)  1983 Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) TEFRA created Medicare risk programs, which allowed federally qualified HMOs and competitive medical plans that met specified Medicare requirements to provide Medicare-covered services under a risk contract. TEFRA today is known as Medicare Part C or Medicare Advantage. The Act also enacted a prospective payment system (PPS), which is a predetermined payment for inpatient services based on diagnoses codes. The PPS went into effect in 1983 and is called diagnosis-related groups (DRGs), which is the hospital inpatient reimbursement system. Peer-review organizations (PROs), now called quality improvement organizations, or QIOs, were also created (Young & Kroth, 2018).
39)  1983 Inpatient Perspective Payment System (IPPS) Medicare IPPS is how hospitals are paid for inpatient stays. Each admission is coded with ICD-10-CM diagnoses and ICD-10-PCS hospital procedure codes. Based on the reason for the admission and the severity of illness and procedures performed, the inpatient stay is assigned a Diagnostic Related Group (DRG). The hospital is paid a flat fee for the cost-based DRG. Reimbursement is based on the primary diagnoses, comorbidities and complications (severity of Illness) and procedures performed (Young & Kroth, 2018; Centers for Medicare & Medicaid Services, 2021a).
40)  1984 CMS Standardization of Information submitted on Medicare Claims HCFA, now known as CMS, required providers to use the HCFA-1500 (now called the CMS-41500) to submit Medicare claims. The HCFA Common Procedure Coding System (HCPCS) (now called Health Care Procedure Coding System) was created, which included CPT, level II (national), and level III (local) codes. Commercial payers also adopted HCPCS coding and use of the CMS-1500 claim form. The CPT codes change yearly because technology and medical advancements drive the changes (Young & Kroth, 2018).
41)  1986 Consolidated Omnibus Budget Reconciliation Act (COBRA) Provides workers and their families who lose their health benefits the right to continue those benefits for 18 months or 36 months due to the death of a spouse (Young & Kroth, 2018).
42)  1988 Clinical Laboratory Improvement Act (CLIA) Clinical Laboratory Improvement Act (CLIA) legislation established quality standards for all laboratory testing to ensure the accuracy, reliability, and timeliness of patient test results regardless of where the test was performed (Centers for Medicare & Medicaid Services, 2021b).
43)  1989 Agency for Healthcare Research and Quality’s (AHRQ) The AHRQ mission is to produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable (Young & Kroth, 2018).
44)  1989 Health Plan Employer Data and Information Set (HEDIS) The National Committee for Quality Assurance (NCQA) developed the HEDIS, which created standards to assess managed care systems using data elements that are collected, evaluated, and published to compare the performance of managed health care plans (Young & Kroth, 2018).
45)  1991 Standardized Evaluation and Management Codes (Physician Office Visit CPT Codes) The AMA and CMS implement major revision of CPT, creating a new section called Evaluation and Management (E/M), which describes patient encounters where the physician must document for quality purpose; past, family and social history (PFSH), physical exam (PE), and medical decision making (MDM) (AMA, 1991).
46)  1991 National Committee for Quality Assurance (NCQA) The NCQA ensures the quality of managed care plans by providing standard and objective information about HMOs (Marjoua & Bozic, 2012).
47)  1992 Resource-Based Relative Value Scale (RBRVS) system Cost-based fee schedule for physicians under Omnibus Reconciliation Acts (OBRA) was created. Each CPT code is assigned a relative value unit (RVU) and multiplied with an annual conversion factor to reimburse the physician more cost-effectively based on their work, overhead, and risk of malpractice (McCormack & Burge, 1994).
48)  1993 Clinton proposed the Health Security Act of 1993 Based on six guiding principles of security, simplicity, savings, choice, quality, and personal responsibility (Young & Kroth, 2018).
49)  1996 National Correct Coding Initiative (NCCI) The NCCI was created to promote correct coding initiatives and to eliminate improper medical coding. NCCI edits are developed based on coding conventions defined in the American Medical Association’s Current Procedural Terminology (CPT) manual (Centers for Medicare & Medicaid Services, 2021f).
50)  1996 Health Insurance Portability and Accountability Act of 1996 (HIPAA) The HIPAA established regulations that govern privacy, security, and electronic transactions standards for health care information. It also created portability of health insurance when an employee terms from their job. The primary intent of HIPAA is to provide better access to health insurance, limit fraud and abuse, and reduce administrative costs (Young & Kroth, 2018).
51)  1997 Balanced Budget Act (BBA); Children’s Health Insurance Plan (CHIP); OIG Fraud & Abuse Audits Title XXI, State Children’s Health Insurance Program (SCHIP) established to provide uninsured, low-income children health insurance under state Medicaid programs. The Balanced Budget Act of 1997 (BBA) addresses health care fraud and abuse issues. The DHHS Office of the Inspector General (OIG) provides investigative and audit services in health care fraud cases (Young & Kroth, 2018).
52)  1999 Center for Improvement in Healthcare Quality (CIHQ) The CIHQ is a membership-based organization comprised primarily of acute care and critical access hospitals, for which it provides accreditation services (Center for Improvement in Healthcare Quality, n.d.).
53)  1999 Omnibus Consolidated and Emergency Supplemental Appropriations Act (OCE- SAA) amended the BBA of 1997 to require the development and implementation of a Home Health Prospective Payment System (HHPPS) The OCE-SAA required the development and implementation of a Home Health Prospective Payment System (HHPPS), which reimburses home health agencies at a predetermined rate for health care services provided to patients. The HHPPS was implemented October 1, 2000, and uses the Outcomes and Assessment Information Set (OASIS), a group of data elements that represent core items of a comprehensive assessment for an adult home care patient and form the basis for measuring patient outcomes for purposes of outcome-based quality improvement (McCall et al., 2013).
54)  2000 Outpatient Prospective Payment System (OPPS) Medicare’s OPPS is used to pay hospital outpatient services. Ambulatory Payment Classifications (APCs) are used to calculate reimbursement and is for hospital-based outpatient claims. It is a cost-based system that uses CPT codes and payment classifications to pay for similar services under group flat fee payments (Centers for Medicare & Medicaid Services, 2021e).
55)  2000 Benefits Improvement and Protection Act of 2000 (BIPA) The Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) requires implementation of a $400 billion prescription drug benefit, improved Medicare Advantage (formerly called Medicare+Choice) benefits, faster Medicare appeals decisions, and more (Young & Kroth, 2018).
56)  2000 Managed Market Competition; Consumer-driven health plans Markets were consolidating and managed care was accelerating, and consumer were driving the insurance market-driven health plans. Consumers want the best health care at the lowest cost. Consumer-driving plans were, for example, employer-paid with high-deductible insurance plans with medical savings accounts used by employees to cover deductibles and other medical costs when covered amounts are exceeded (Well, 2002).
57)  2001 Administrative Simplification Compliance Act (ASCA) The ASCA establishes the compliance date (October 16, 2003) for modifications to the Electronic Transaction Standards and Code Sets as required by HIPAA. Covered entities must submit Medicare claims electronically unless the Secretary of DHHS grants a waiver (Centers for Medicare & Medicaid Services, 2021c).
58)  2002 announced that quality improvement organizations (QIOs) CMS OIOs perform utilization and quality control review of health care furnished, or to be furnished, to Medicare beneficiaries. QIOs replaced peer review organizations (PROs), which previously performed this function (Young & Kroth, 2018).
59)  2005 National Provider Identifier, NPI The Standard Unique Health Identifier for Health Care Providers (or National Provider Identifier, NPI) is implemented (Centers for Medicare & Medicaid Services, 2021c).
60)  2005 Patient Safety and Quality Improvement Act of 2005 Amends Title IX of the Public Health Service Act to provide for improved patient safety and reduced incidence of events adversely affecting patient safety. It encourages the reporting of health care mistakes to patient safety organizations by making the reports confidential and shielding them from use in civil and criminal proceedings (Centers for Medicare & Medicaid Services, 2021c).
61)  2005 Deficit Reduction Act of 2005 Created the Medicaid Integrity Program (MIP), which is a fraud and abuse detection initiative and program (Young & Kroth, 2018).
62)  2006 Physician Quality Reporting Initiative (PQRI) or System (PQRS) The Tax Relief and Health Care Act of 2006 (TRHCA) authorized implementation of a physician quality reporting system that establishes a financial incentive for eligible professionals who participate in a voluntary quality reporting program (Young & Kroth, 2018).
63)  2009 American Recovery and Reinvestment Act of 2009 The American Recovery and Reinvestment Act (ARRA) authorized an expenditure of $1.5 billion for grants for construction, renovation and equipment, and the acquisition of health information technology systems (Young & Kroth, 2018).
64)  2009 Health Information Technology for Economic and Clinical Health (HITECH) Act The Health Information Technology for Economic and Clinical Health (HITECH) Act provides DHHS with the authority to establish programs to improve health care quality, safety, and efficiency through the promotion of health IT, including electronic health records and private and secure electronic health information exchange (Young & Kroth, 2018).
65)  2010 Patient Protection and Affordable Care Act (2010) The PPACA (2010) provides quality affordable access to health insurance for Americans. The Act provides a broader range of mandated prevention services, where patients are not to be charged copayments or deductibles on those services to incent them to get the preventive services. The Act eliminates lifetime caps on benefits and extends coverage of college students to age 26 (Young & Kroth, 2018).
66)  2014 National Coordinator for Health Information Technology (ONC) The ONC is the office that supports the administration’s healthIT.gov efforts. It is a primary resource to the entire health system to support the adoption of health information technology and the promotion of nationwide, standards-based health information exchange (HealthIT.gov, 2021).
67)  2015 Hospital Quality Reporting (HQR) and Initiative (H.Q.I.) The HQR began in 2003, mandated by the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003. Failure to successfully report resulted in a 0.4 percentage point reduction in the annual market basket used in the reimbursement. This increased to a 2.0 percent reduction under the Deficit Reduction Act of 2005. Under the American Recovery and Reinvestment Act of 2009 and the Affordable Care Act of 2010 the reduction is one-quarter of the hospital’s applicable annual payment rate in 2015 and beyond if all Hospital Inpatient Quality Reporting Program requirements are not met (Centers for Medicare & Medicaid Services, 2021d).
68)  2015 Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and Merit-based Incentive Payment System (MIPS) Repeals the Sustainable Growth Rate (PDF) formula, value-based purchasing. Implements MIPS, which combines the former PQRS reporting system with ePrescribe and meaningful use into the one program with four (4) components (Quality Payment Program, n.d.).
69)  2021 American Rescue Plan Act (ARPA) The American Rescue Plan Act of 2021, also called the COVID-19 Stimulus Package or American Rescue Plan. The ARPA expands A.C.A. health insurance subsidies and lowers costs (Centers for Medicare & Medicaid Services, 2021c).
70)  2021 Medicare Care Compare Medicare search engines that allow Medicare recipients to sign up, log in, and find and compare nursing homes, hospitals, physicians, other providers of care. There is also a look up externally for non-Medicare patients, but the data is limited. The compare data compares from the quality measures and cost data submitted through the quality reporting programs. The data provides transparency and was initiated by the consumerism movement in health care (Medicare.gov, 2021).
71)  2030-2000 Healthy People 2000, 2010,  2020, 2030 Healthy People 2030 is the fifth decade of the program. Healthy People 1990 began a ten-year population health initiative. Every ten years since its inception goals have been set, population health data is measured and outcomes are analyzed. The 1990 to 2000 span of time was the baseline of the program. For Healthy People 2000, the second iteration of the initiative, was guided by 3 broad goals: a) increase the span of healthy life, b) reduce health disparities and c) achieve access to preventive services for all. For Healthy People 2010, the focus increased on improving quality of life. The one significant overarching goal was to eliminate health disparities and not just simply reduce them. For Healthy People 2020 there were four goals: a) attain a high-quality of life; b) live longer without preventable disease, disability, injury, or premature death; c) achieve health equity and eliminate disparities; and d) improve all groups in regard to health status. Finally, for Healthy People 2030, the fifth iteration rolled out in August 2021, there is increased emphasis on the lessons learned over the last 4 decades to improve health equity, health literacy, and a new concentration on well-being (Health.gov, n.d.; Kroth, & Young, 2018).

 

 

 

References

 

Achermann, J. (2009). Small gifts and big trouble: Clarifying the Taft Hartley act. University of San Francisco Law Review, 44(1), 63–94.

American Association for Accreditation of Ambulatory Surgery Facilities. (n.d.). We maintain the highest standards for outpatient accreditation. https://www.aaaasf.org/who-we-are/

Center for Improvement in Healthcare Quality. (n.d.). Welcome to CIHQ. https://www.cihq.org/

Centers for Medicare & Medicaid Services. (2021a). Acute inpatient PPS. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS

Centers for Medicare & Medicaid Services. (2021b). Clinical laboratory improvement amendments (CLIA). https://www.cms.gov/Regulations-and-Guidance/Legislation/CLIA

Centers for Medicare & Medicaid Services. (2021c). CY 2002 Physician fee schedule proposed rule with comment period. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched

Centers for Medicare & Medicaid Services. (2021d). Hospital inpatient quality reporting program. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/HospitalRHQDAPU

Centers for Medicare & Medicaid Services. (2021e). Hospital outpatient prospective payment system (OPPS). https://www.cms.gov/Research-Statistics-Data-and-Systems/Files-for-Order/LimitedDataSets/HospitalOPPS

Centers for Medicare & Medicaid Services. (2021f). National correct coding initiative edits. https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd

Chaudhry, H.J. (2010). The important role of medical licensure in the United States. Academic Medicine, 85(11), 1657. doi:10.1097/ACM.0b013e3181f557ed

Derickson A. (2002). “Health for three-thirds of the nation:” Public health advocacy of universal access to medical care in the United States. American Journal of Public Health, 92(2), 180–190. https://doi.org/10.2105/ajph.92.2.180

Dotson P. (2013). CPT® Codes: What are they, why are they necessary, and how are they developed?. Advances in Wound Care, 2(10), 583–587. https://doi.org/10.1089/wound.2013.0483

Gabay M. (2013). The federal controlled substances act: Schedules and pharmacy registration. Hospital pharmacy, 48(6), 473–474. https://doi.org/10.1310/hpj4806-473

Health.gov. (n.d.). History of healthy people. https://health.gov/our-work/healthy-people/about-healthy-people/history-healthy-people

HealthIT.gov. (2021). https://www.healthit.gov/

Marjoua, Y., & Bozic, K. J. (2012). Brief history of quality movement in US healthcare. Current reviews in Musculoskeletal Medicine, 5(4), 265–273. https://doi.org/10.1007/s12178-012-9137-8

McCall, N., Korb, J., Petersons, A., & Moore, S. (2003). Reforming Medicare payment: Early effects of the 1997 Balanced Budget Act on postacute care. The Milbank Quarterly, 81(2), 277–173. https://doi.org/10.1111/1468-0009.t01-1-00054

McCormack, L. A., & Burge, R. T. (1994). Diffusion of Medicare’s RBRVS and related physician payment policies. Health Care Financing Review, 16(2), 159-173. https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/HealthCareFinancingReview/Downloads/CMS1191353dl.pdf

Medicare.gov. (2021). Find & compare nursing homes, hospitals & other providers near you.  https://www.medicare.gov/care-compare/

Moehling, C. M., & Thomasson, M. A. (2012, April). Saving babies: The contribution of Sheppard-Towner to the decline in infant mortality in the 1920s (Working Paper 17996.). National Bureau of Economic Research. https://www.nber.org/system/files/working_papers/w17996/w17996.pdf

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Scofea,L. A. (1994). The development and growth of employer-provider health insurance. Monthly Labor Review, 117(3), 3–10. https://www.bls.gov/opub/mlr/1994/03/art1full.pdf

Svahn, J. A. (1981). Omnibus Reconciliation Act of 1981: Legislative history and summary of OASDI and Medicare provisions. Social Security Bulletin., 44(10). https://www.ssa.gov/policy/docs/ssb/v44n10/v44n10p3.pdf

Truex E. S. (2014). Medical licensing and discipline in America: A history of the Federation of State Medical Boards. Journal of the Medical Library Association, 102(2), 133–134. https://doi.org/10.3163/1536-5050.102.2.019

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The Healthcare Quality Evolution

 

 

NR360 Information Systems in Healthcare

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NR360 Information Systems in Healthcare

Purpose

The purpose of this assignment is to investigate informatics in healthcare and to apply professional, ethical, and legal principles to its appropriate use in healthcare technology. NR360 Information Systems in Healthcare 

Course outcomes: This assignment enables the student to meet the following course outcomes:

CO 4: Investigate safeguards and decision‐making support tools embedded in patient care technologies and information systems to support a safe practice environment for both patients and healthcare workers. (PO 4)

CO 6: Discuss the principles of data integrity, professional ethics, and legal requirements related to data security, regulatory requirements, confidentiality, and client’s right to privacy. (PO 6)

CO 8: Discuss the value of best evidence as a driving force to institute change in the delivery of nursing care. (PO 8)

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Due date: Your faculty member will inform you when this assignment is due. The Late Assignment Policy applies to this assignment.

Total points possible: 240 points

Requirements:

  • Research, compose, and type a scholarly paper based on the scenario provided by your faculty, and choose a conclusion scenario to discuss within the body of your paper. Reflect on lessons learned in this class about technology, privacy concerns, and legal and ethical issues and address each of these concepts in the paper. Consider the consequences of such a scenario. Do not limit your review of the literature to the nursing discipline only because other health professionals are using the technology, and you may need to apply critical thinking skills to its applications in this scenario.
  • Use Microsoft Word and APA formatting. Consult your copy of the Publication Manual of the American Psychological Association, as well as the resources in Doc Sharing if you have questions (e.g., margin size, font type and size (point), use of third person, etc.). Take advantage of the writing service SmartThinking, which is accessed by clicking on the link called the Tutor Source, found under the Course Home
  • The length of the paper should be four to five pages, excluding the title page and the reference page. Limit the references to a few key sources (minimum of three required).
  • The paper will contain an introduction that catches the attention of the reader, states the purpose of the paper, and provides a narrative outline of what will follow (i.e., the assignment criteria).
  • In the body of the paper, discuss the scenario in relation to HIPAA, legal, and other regulatory requirements that apply to the scenario and the ending you chose. Demonstrate support from sources of evidence (references) included as in‐text citations.
  • Choose and identify one of the possible endings provided for the scenario, and construct your paper based on its implications to the scenario. Make recommendations about what should have been done and what could be done to correct or mitigate the problems caused by the scenario and the ending you Demonstrate support from

sources of evidence (references) included as in‐text citations.

  • Present the advantages and disadvantages of informatics relating to your scenario and describe professional and ethical principles appropriate to your chosen ending. Use facts from supporting sources of evidence, which must be included as in‐text citations.
  • The paper’s conclusion should summarize what you learned and make reflections about them to your
  • Use the “Directions and Assignment Criteria” and “Grading Rubric” below to guide your writing and ensure that all

components are complete.

  • Review the section on Academic Honesty found in the Chamberlain Course Policies. All work must be original (in your own words). Papers will automatically be submitted to TurnItIn when submitted to the Dropbox.

 

  • Submit the completed paper to the “We Can But Dare We?” Dropbox by the end of Week 3. Please refer to the Syllabus for due dates for this assignment. For online students, please post questions about this assignment to the weekly Q & A Forums so that the entire class may view the

 

Preparing the assignment

Background

Healthcare is readily embracing any technology to improve patient outcomes, streamline operations, and lower costs, but we must also consider the impact of such technology on privacy and patient care.

 

Your faculty member will provide a scenario for you to address in your paper. NR360 Information Systems in Healthcare 

 

Choose an ending to the scenario, and construct your paper based on those reflections.

Choose one of the following outcomes:

  1. A HIPAA violation occurs, and client data is exposed to the
  2. A medication error has harmed a
  3. A technology downtime that impacts patient care occurs, and an error is
  4. A ransomware attack has occurred, and the organization must contemplate paying the ransom or lose access to patient data.

Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions. Include the following sections:

  1. Introduction – 40 points/17%
    • Catches attention of the reader
    • States purpose of the paper
    • Provides a narrative outline of the paper (i.e., the assignment criteria)
  2. HIPAA, Legal, and Regulatory Discussion – 40 points/17%
    • Presents evidence from recent scholarly publications to address the impact of technology on nursing care related to:
      • Patient privacy and HIPAA standards
      • Healthcare regulations
      • Legal guidelines on appropriate use of technology
  1. Scenario Ending and Recommendations – 50 points/21%
    • Selects and presents one scenario ending as the focus of the
    • Evaluates the actions taken by healthcare providers as the situation
    • Recommends actions that could have been taken to mitigate the circumstances presented in the selected scenario
    • Supports recommendations with evidence from recent scholarly
  2. Advantages and Disadvantages – 50 points/21%
    • Presents evidence from recent scholarly publications to address the impact of technology on nursing care related to:
      • The advantages of appropriately using technology in healthcare
      • Risks of technology use in healthcare
    • Describes professional and ethical principles guiding the appropriate use of technology in
  3. Conclusion and Reflections – 30 points/12%
    • Summarizes what new information was learned by completing this
    • Reflects on how this new knowledge will impact future behavior as a healthcare
  4. Scholarly Writing and APA Format – 30 points/12%
    • Paper submitted as a Microsoft Word
    • Adheres to current APA formatting guidelines including proper use of:
      • Title page
      • Running head
      • Page numbers
    • Length is 4-5 pages, excluding title and reference pages.
    • Includes at least three (3) references that are:
      • From recent (within the last 5 years) scholarly sources
      • Cited in text appropriately
      • Included on an APA formatted reference page
    • Scholarly writing reflects:
      • Accurate spelling
      • Correct use of professional grammar
      • Logical organization of thoughts (mechanics)

 

For writing assistance, visit the Writing Center.

 

Please note that your instructor may provide you with additional assessments in any form to determine that you fully understand the concepts learned in the review module.

 

 

Grading Rubric Criteria are met when the student’s application of knowledge demonstrates achievement of the outcomes for this assignment.

Assignment Section and Required Criteria

(Points possible/% of total points available)

 Highest Level of Performance High Level of Performance Satisfactory Level of Performance Unsatisfactory Level of Performance Section not present in paper
Introduction

(40 points/17%)

 40 points 36 points 32 points 15 points 0 points
Required criteria

·         Catches attention of the reader.

·         States purpose of the paper.

·         Provides a narrative outline of the paper (i.e., the assignment criteria).

 Meets all requirements for section. Includes no fewer than 2 requirements for section. Includes no less than 1 requirement for section. Present, yet includes no required criteria. No requirements for this section presented.
HIPAA, Legal, and Regulatory Discussion

(40 points/17%)

 40 points 36 points 32 points 15 points 0 points
Required criteria

Presents evidence from recent scholarly publications to address the impact of technology on nursing care related to:

·         Patient privacy and HIPAA standards

·         Healthcare regulations

·         Legal guidelines on appropriate use of technology

 Meets all requirements for section. Includes no fewer than 2 requirements for section. Includes no fewer than 1 requirement for section. Present, yet includes no required criteria. No requirements for this section presented.
Scenario Ending and Recommendations

(50 points/21%)

 50 points 46 points 42 points 19 points 0 points
Required criteria

·         Selects and presents one scenario ending as the focus of the assignment.

·         Evaluates the actions taken by healthcare providers as the situation evolved.

·         Recommends actions that could have been taken to mitigate the circumstances presented in the selected scenario ending. Supports recommendations with evidence from

·         recent scholarly publications.

 Meets all requirements for section. Includes no fewer than 3 requirements for section. Includes 1-2 requirements for section. Section present yet includes no required criteria. No requirements for this section presented.

 

 

Assignment Section and Required Criteria

(Points possible/% of total points available)

 Highest Level of Performance High Level of Performance Satisfactory Level of Performance Unsatisfactory Level of Performance Section not present in paper
·         Supports recommendations with evidence from

recent scholarly publications.

          
Advantages and Disadvantages

(50 points/21%)

 50 points 42 points 19 points 0 points
Required criteria

·         Presents evidence from recent scholarly publications to address the impact of technology on nursing care.

·         Evidence includes the advantages of appropriately using technology in healthcare.

·         Evidence includes risks of inappropriately using technology in healthcare.

·         Describes professional and ethical principles guiding the appropriate use of technology in healthcare.

 Meets all requirements for section. Includes no fewer than 3 requirements for section. Includes 1-2 requirements for section. No requirements for this section presented.
Conclusion and Reflections

(30 points/12%)

 30 points 15 points 0 points
Required criteria

·         Summarizes new information learned by completing this assignment.

·         Reflects on how this new knowledge will impact future behavior as a healthcare professional.

 Meets all requirements for section. Includes 1 requirement for section. No requirements for this section presented.
Scholarly Writing and APA Format

(30 points/12%)

 30 points 9 points 8 points 4 points 0 points
Required criteria

·         Paper submitted as a Microsoft Word document.

·         Adheres to current APA formatting guidelines including proper use of:

 Meets all requirements for section. Includes no fewer than 4 fully met requirements for section. Includes no fewer than 3 fully met requirements for section. Includes 1-2 requirements fully met requirements for section. No requirements for this section presented.

 

 

Assignment Section and Required Criteria

(Points possible/% of total points available)

 Highest Level of Performance High Level of Performance Satisfactory Level of Performance Unsatisfactory Level of Performance Section not present in paper
o   Title page

o   Running head

o   Page numbers

·         Length is 4-5 pages, excluding title and reference pages.

·         Includes at least three (3) references that are:

o   From recent (within the last 5 years) scholarly sources

o   Cited in text appropriately

o   Included on an APA formatted reference page

·         Scholarly writing reflects:

o   Accurate spelling

o   Correct use of professional grammar

o   Logical organization of thoughts (mechanics)

          
Total Points Possible = 240 points

 

Interdisciplinary Plan Proposal

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Interdisciplinary Plan Proposal

Assessment 3 Instructions: Interdisciplinary Plan Proposal

Top of Form

Bottom of Form

  • PRINT
  • For this assessment you will create a 2-4 page plan proposal for an interprofessional team to collaborate and work toward driving improvements in the organizational issue you identified in the second assessment.

The health care industry is always striving to improve patient outcomes and attain organizational goals. Nurses can play a critical role in achieving these goals; one way to encourage nurse participation in larger organizational efforts is to create a shared vision and team goals (Mulvale et al., 2016). Participation in interdisciplinary teams can also offer nurses opportunities to share their expertise and leadership skills, fostering a sense of ownership and collegiality.

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You are encouraged to complete the Budgeting for Nurses activity before you develop the plan proposal. The activity consists of seven questions that will allow you the opportunity to check your knowledge of budgeting basics and as well as the value of financial resource management. The information gained from completing this formative will promote success with the Interdisciplinary Plan Proposal. Completing this activity also demonstrates your engagement in the course, requires just a few minutes of your time, and is not graded. Interdisciplinary Plan Proposal

Demonstration of Proficiency

  • Competency 1: Explain strategies for managing human and financial resources to promote organizational health.
    • Explain organizational resources, including a financial budget, needed for the plan to be a success and the impacts on those resources if nothing is done, related to the improvements sought by the plan.
  • Competency 2: Explain how interdisciplinary collaboration can be used to achieve desired patient and systems outcomes.
    • Describe an objective and predictions for an evidence-based interdisciplinary plan to achieve a specific objective related to improving patient or organizational outcomes.
    • Explain the collaboration needed by an interdisciplinary team to improve the likelihood of achieving the plan’s objective. Include best practices of interdisciplinary collaboration from the literature.
  • Competency 4: Explain how change management theories and leadership strategies can enable interdisciplinary teams to achieve specific organizational goals.
    • Explain a change theory and a leadership strategy, supported by relevant evidence, that are most likely to help an interdisciplinary team succeed in collaborating and implementing, or creating buy-in for, the project plan.
  • Competency 5: Apply professional, scholarly, evidence-based communication strategies to impact patient, interdisciplinary team, and systems outcomes.
    • Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
    • Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.

Reference

Mulvale, G., Embrett, M., & Shaghayegh, D. R. (2016). ‘Gearing up’ to improve interprofessional collaboration in primary care: A systematic review and conceptual framework. BMC Family Practice, 17.

Professional Context

This assessment will allow you to describe a plan proposal that includes an analysis of best practices of interprofessional collaboration, change theory, leadership strategies, and organizational resources with a financial budget that can be used to solve the problem identified through the interview you conducted in the prior assessment.

Scenario

Having reviewed the information gleaned from your professional interview and identified the issue, you will determine and present an objective for an interdisciplinary intervention to address the issue.

Note: You will not be expected to implement the plan during this course. However, the plan should be evidence-based and realistic within the context of the issue and your interviewee’s organization.

Instructions

For this assessment, use the context of the organization where you conducted your interview to develop a viable plan for an interdisciplinary team to address the issue you identified. Define a specific patient or organizational outcome or objective based on the information gathered in your interview.

The goal of this assessment is to clearly lay out the improvement objective for your planned interdisciplinary intervention of the issue you identified. Additionally, be sure to further build on the leadership, change, and collaboration research you completed in the previous assessment. Look for specific, real-world ways in which those strategies and best practices could be applied to encourage buy-in for the plan or facilitate the implementation of the plan for the best possible outcome.

Using the Interdisciplinary Plan Proposal Template [DOCX] will help you stay organized and concise. As you complete each section of the template, make sure you apply APA format to in-text citations for the evidence and best practices that inform your plan, as well as the reference list at the end.

Additionally, be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.

  • Describe an objective and predictions for an evidence-based interdisciplinary plan to achieve a specific goal related to improving patient or organizational outcomes.
  • Explain a change theory and a leadership strategy, supported by relevant evidence, that is most likely to help an interdisciplinary team succeed in collaborating and implementing, or creating buy-in for, the project plan.
  • Explain the collaboration needed by an interdisciplinary team to improve the likelihood of achieving the plan’s objective. Include best practices of interdisciplinary collaboration from the literature.
  • Explain organizational resources, including a financial budget, needed for the plan to succeed and the impacts on those resources if the improvements described in the plan are not made.
  • Communicate the interdisciplinary plan, with writing that is clear, logically organized, and professional, with correct grammar and spelling, using current APA style.

Additional Requirements

  • Length of submission: Use the provided template. Remember that part of this assessment is to make the plan easy to understand and use, so it is critical that you are clear and concise. Most submissions will be 2 to 4 pages in length. Be sure to include a reference page at the end of the plan.
  • Number of references:Cite a minimum of 3 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than 5 years old.
  • APA formatting:Make sure that in-text citations and reference list follow current APA style.

Note: Faculty may use the Writing Feedback Tool when grading this assessment. The Writing Feedback Tool is designed to provide you with guidance and resources to develop your writing based on five core skills. You will find writing feedback in the Scoring Guide for the assessment, once your work has been evaluated.

Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final Capstone course.

  • SCORING GUIDE

Use the scoring guide to understand how your assessment will be evaluated.


Interdisciplinary Plan Proposal Scoring Guide

CRITERIA NON-PERFORMANCE BASIC PROFICIENT DISTINGUISHED
Describe an objective and predictions for an evidence-based interdisciplinary plan to achieve a specific goal related to improving patient or organizational outcomes. Does not describe an objective and predictions for an evidence-based interdisciplinary plan to achieve a specific goal related to improving patient or organizational outcomes. Identifies an objective for an evidence-based interdisciplinary plan but does not clearly explain how the objective will help achieve a specific goal related to improving patient or organizational outcomes. Describes an objective and predictions for an evidence-based interdisciplinary plan to achieve a specific goal related to improving patient or organizational outcomes. Describes an objective and predictions for an evidence-based interdisciplinary plan to achieve a specific goal related to improving patient or organizational outcomes, including methods from the literature that may be used to determine success.
Explain a change theory and a leadership strategy, supported by relevant evidence, that is most likely to help an interdisciplinary team succeed in collaborating and implementing, or creating buy-in for, the project plan. Does not explain a change theory and a leadership strategy, supported by relevant evidence, that is most likely to help an interdisciplinary team succeed in collaborating and implementing, or creating buy-in for, the project plan. Describes a change theory and a leadership strategy but the relevance to the success of interdisciplinary team in collaborating and implementing, or creating buy-in for, the project plan is not clearly explained and no evidence is provided. Explains a change theory and a leadership strategy, supported by relevant evidence, that is most likely to help an interdisciplinary team succeed in collaborating and implementing, or creating buy-in for, the project plan. Explains a change theory and a leadership strategy, supported by relevant evidence, that is most likely to help an interdisciplinary team succeed in collaborating and implementing, or creating buy-in for, the project plan, providing real-world examples relevant to the health care organization that is the context for the plan.
Explain the collaboration needed by an interdisciplinary team to improve the likelihood of achieving the plan’s objective, including best practices of interdisciplinary collaboration from the literature. Does not explain the collaboration needed by an interdisciplinary team to improve the likelihood of achieving the plan’s objective. Does not cite best practices of interdisciplinary collaboration from the literature. Explains collaboration but not in terms of an interdisciplinary team or does not include best practices from the literature. Explains the collaboration needed by an interdisciplinary team to improve the likelihood of achieving the plan’s objective, including best practices of interdisciplinary collaboration from the literature. Explains the collaboration needed by an interdisciplinary team to improve the likelihood of achieving the plan’s objective, including best practices of interdisciplinary collaboration from the literature. Provides real-world examples relevant to the health care organization that is the context for the plan.
Explain organizational resources, including a financial budget, needed for the plan to succeed and the impacts on those resources if nothing is done to make the improvements sought by the plan. Does not explain organizational resources, including a financial budget, needed for the plan to succeed and the impacts on those resources if nothing is done to make the improvements sought by the plan. Identifies organizational resources needed for the plan to succeed and the impacts on those resources if nothing is done to make the improvements sought by the plan. Does not include a financial budget. Explains organizational resources, including a financial budget, needed for the plan to succeed and the impacts on those resources if nothing is done to make the improvements sought by the plan. Explains organizational resources, including a financial budget, needed for the plan to succeed and the impacts on those resources if nothing is done to make the improvements sought by the plan. Provides real-world examples relevant to the health care organization that is the context for the plan.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling. Does not organize content for ideas. Lacks logical flow and smooth transitions. Organizes content with some logical flow and smooth transitions. Contains errors in grammar/punctuation, word choice, and spelling. Organizes content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling. Organizes content with a clear purpose. Content flows logically with smooth transitions using coherent paragraphs, correct grammar/punctuation, word choice, and free of spelling errors.
Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format. Does not apply APA formatting to headings, in-text citations, and references. Does not use quotes or paraphrase correctly. Applies APA formatting to in-text citations, headings and references incorrectly and/or inconsistently, detracting noticeably from the content. Inconsistently uses headings, quotes and/or paraphrasing. Applies APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format. Exhibits strict and flawless adherence to APA formatting of headings, in-text citations, and references. Quotes and paraphrases correctly.

 

Applying PDSA

  • Crowfoot, D., & Prasad, V. (2017). Using the Plan-Do-Study-Act (PSDA) cycle to make change in general practice. InnovAIT, 10(7), 425–430.
    • This article details principles of PDSA, offering a variety of resources for implementing and assessing the success of change efforts.
  • McNamara, D. A., Rafferty, P., & Fitzpatrick, F. (2016). An improvement model to optimise hospital interdisciplinary learning. International Journal of Health Care Quality Assurance, 29(5), 550–558.
    • This article presents a study in which the PDSA cycle was applied to drive continuous improvement in interdisciplinary learning within a health care setting.
  • Institute for Healthcare Improvement. (n.d.). Plan-Do-Study-Act (PDSA) worksheet. http://www.ihi.org/resources/Pages/Tools/PlanDoStudyActWorksheet.aspx
    • While you are not expected to use this worksheet, it has been used in many health care organizations and is offered as a supplementary resource.
  • McGowan, M., & Reid, B. (2018). Using the Plan, Do, Study, Act cycle to enhance a patient feedback system for older adults. British Journal of Nursing, 27(16), 936–941.
    • This article presents a study in which PDSA was used to refine a patient-feedback system.

 

Evidence-Based Practice and Improvement

  • Duffy, J. R., Culp, S., Marchessault, P., & Olmsted, K. (2020). Longitudinal comparison of hospital nurses’ values, knowledge, and implementation of evidence-based practice. The Journal of Continuing Education in Nursing, 51(5), 209‒214.
    • This article reviews the results of a study looking at how a hospital-based residency program helps the RN to administer EBP care.
  • Friesen, M., Brady, J., Miligan, R., & Christensen, P. (2017). Findings from a pilot study: Bringing evidence-based practice to the bedside. Worldviews of Evidence Based Nursing, 14(1), 22‒34.
    • This article reviews the results of a study designed to evaluate a structured EBP educational process with mentoring.
  • Rahmayanti, E. I., Kadar, K. S., & Saleh, A. (2020). Readiness, barriers, and potential strength of nursing in implementing evidence-based practice. International Journal of Caring Sciences, 13(2), 1203‒1211.
    • This article identifies the readiness, barriers and strengths to carry out EBP care.
  • Woods, A. (n.d.). Evidence-based practice: Improving practice, improving outcomes (Part one)[Video] | Transcript. https://www.youtube.com/watch?v=OvenUa3Ww8o
    • This video discusses the value of, and current challenges in, implementing evidence-based practice in health care organizations.

 

Budgeting

  • Kolakowski, D. (2016). Constructing a nursing budget using a patient classification system. Nursing Management, 47(2), 14–16.
    • This article provides guidelines for creating a budget.
  • Rundio, A. (2016). The nurse manager’s guide to budgeting & finance(2nd ed.). Indianapolis, IN: Sigma Theta International.
    • The following chapters will help you to develop a basic understanding of budgeting in health care settings.
      • Chapter 1, “Budgeting for the Nurse Manager.”
      • Chapter 4, “Budget Development.”

Staffing

  • van Oostveen, C. J., Ubbink, D. T., Mens, M. A., Pompe, E. A., & Vermeulen, H. (2016). Pre-implementation studies of a workforce planning tool for nurse staffing and human resource management in university hospitals. Journal of Nursing Management, 24(2), 184–191.
    • This paper presents an analysis of a workforce planning tool prior to its implementation.
    • In addition to ideas on human resources planning, this article may prompt some things for you to consider before beginning your plan proposal.

 

Interview and Interdisciplinary Issue Identification

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Interview and Interdisciplinary Issue Identification

Assessment 2 Instructions: Interview and Interdisciplinary Issue Identification

Top of Form

Bottom of Form

  • PRINT
  • For this assessment, you will create a 2-4 page report on an interview you have conducted with a health care professional. You will identify an issue from the interview that could be improved with an interdisciplinary approach, and review best practices and evidence to address the issue.

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As a baccalaureate-prepared nurse, your participation and leadership in interdisciplinary teams will be vital to the health outcomes for your patients and organization. One way to approach designing an improvement project is to use the Plan-Do-Study-Act (PDSA) cycle. The Institute for Healthcare Improvement describes it thus:

The Plan-Do-Study-Act (PDSA) cycle is shorthand for testing a change in the real work setting—by planning it, trying it, observing the results, and acting on what is learned. This is the scientific method adapted for action-oriented learning…Essentially, the PDSA cycle helps you test out change ideas on a smaller scale before evaluating the results and making adjustments before potentially launching into a somewhat larger scale project (n.d.).

You might also recognize that the PDSA cycle resembles the nursing process. The benefit of gaining experience with this model of project design is that it provides nurses with an opportunity to ideate and lead improvements. For this assessment, you will not be implementing all of the PDSA cycle. Instead, you are being asked to interview a health care professional of your choice to determine what kind of interdisciplinary problem he or she is experiencing or has experienced in the workplace. This interview, in Assessment 2, will inform the research that you will conduct to propose a plan for interdisciplinary collaboration in Assessment 3.

It would be an excellent choice to complete the PDSA Cycle activity prior to developing the report. The activity consists of four questions that create the opportunity to check your understanding of best practices related to each stage of the PDSA cycle. The information gained from completing this formative will promote your success with the Interview and Interdisciplinary Issue Identification report. This will take just a few minutes of your time and is not graded.

Reference

Institute for Healthcare Improvement. (n.d.). How to improve. http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx

Demonstration of Proficiency

  • Competency 2: Explain how interdisciplinary collaboration can be used to achieve desired patient and systems outcomes.
    • Summarize an interview focused on past or current issues at a health care organization.
    • Describe collaboration approaches from the literature that could be relevant in establishing or improving an interdisciplinary team to address an organizational issue.
  • Competency 3: Describe ways to incorporate evidence-based practice within an interdisciplinary team.
    • Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate.
  • Competency 4: Explain how change management theories and leadership strategies can enable interdisciplinary teams to achieve specific organizational goals.
    • Describe change theories and a leadership strategy that could help develop an interdisciplinary solution to an organizational issue.
  • Competency 5: Apply professional, scholarly, evidence-based communication strategies to impact patient, interdisciplinary team, and systems outcomes.
    • Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
    • Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.

Professional Context

This assessment will introduce the Plan-Do-Study-Act (PDSA) Model to create change in an organization. By interviewing a colleague of your choice, you will begin gathering information about an interprofessional collaboration problem that your colleague is experiencing or has experienced. You will identify a change theory and leadership strategies to help solve this problem.

Scenario

This assessment is the first of three related assessments in which you will gather interview information (Assessment 2); design a proposal for interdisciplinary problem-solving, (Assessment 3); and report on how an interdisciplinary improvement plan could be implemented in a place of practice (Assessment 4). At the end of the course, your interviewee will have a proposal plan based on the PDSA cycle that he or she could present to stakeholders to address an interdisciplinary problem in the workplace.

For this assessment, you will need to interview a health care professional such as a fellow learner, nursing colleague, administrator, business partner, or another appropriate person who could provide you with sufficient information regarding an organizational problem that he or she is experiencing or has experienced, or an area where they are seeking improvements. Consult the Interview Guide [DOCX] for an outline of how to prepare and the types of information you will need to complete this project successfully.

Remember: this is just the first in a series of three assessments.

Instructions

For this assessment, you will report on the information that you collected in your interview, analyzing the interview data and identifying a past or current issue that would benefit from an interdisciplinary approach. This could be an issue that has not been addressed by an interdisciplinary approach or one that could benefit from improvements related to the interdisciplinary approach currently being used. You will discuss the interview strategy that you used to collect information. Your interview strategy should be supported by citations from the literature. Additionally, you will start laying the foundation for your Interdisciplinary Plan Proposal (Assessment 3) by researching potential change theories, leadership strategies, and collaboration approaches that could be relevant to issue you have identified. Please be certain to review the scoring guide to confirm specific required elements of this assessment. Note that there are differences between basic, proficient and distinguished scores.

When submitting your plan, use the Interview and Issue Identification Template [DOCX], which will help you to stay organized and concise. As you complete the template, make sure you use APA format for in-text citations for the evidence and best practices that are informing your plan, as well as for the reference list at the end.

Additionally, be sure to address the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.

  • Summarize an interview focused on past or current issues at a health care organization.
  • Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate.
  • Describe potential change theories and leadership strategies that could inform an interdisciplinary solution to an organizational issue.
  • Describe collaboration approaches from the literature that could facilitate establishing or improving an interdisciplinary team to address an organizational issue.
  • Communicate with writing that is clear, logically organized, and professional, with correct grammar and spelling, and using current APA style.

Additional Requirements

  • Length of submission: Use the provided template. Most submissions will be 2 to 4 pages in length. Be sure to include a reference page at the end of the plan.
  • Number of references:Cite a minimum of 3 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than 5 years old.
  • APA formatting:Make sure that in-text citations and reference list follow current APA style.

Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final Capstone course.

  • SCORING GUIDE

Use the scoring guide to understand how your assessment will be evaluated.

 

 

Interview and Interdisciplinary Issue Identification Scoring Guide

CRITERIA NON-PERFORMANCE BASIC PROFICIENT DISTINGUISHED
Summarize an interview focused on past or current issues at a health care organization. Does not summarize an interview focused on past or current issues at a health care organization. Discusses an interview, but the focus of the interview, the issues addressed, or the specifics of health care organizational context are unclear or missing. Summarizes an interview focused on past or current issues at a health care organization. Summarizes an interview focused on past or current issues at a health care organization. Notes strategies employed in the interview to ensure that sufficient information was gathered.
Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate. Does not identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate. Identifies an issue with an unclear connection to the interview or for which an evidence-based interdisciplinary approach seems inappropriate. Identifies an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate. Identifies an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate, providing one or more specific reasons to justify this approach.
Describe potential change theories and leadership strategies that could help develop an interdisciplinary solution to an organizational issue. Does not describe potential change theories and leadership strategies that could help develop an interdisciplinary solution to an organizational issue. Identifies change theories and leadership strategies that are unclear, incomplete, or irrelevant to developing an interdisciplinary solution to an organizational issue. Describes potential change theories and leadership strategies that could help develop an interdisciplinary solution to an organizational issue. Describes potential change theories and leadership strategies that could help develop an interdisciplinary solution to an organizational issue. Notes which sources seem most credible or relevant to the specific organizational issue.
Describe collaborative approaches from the literature that could be relevant in establishing or improving an interdisciplinary team to address an organizational issue. Does not describe collaborative approaches from the literature that could be relevant in establishing or improving an interdisciplinary team to address an organizational issue. Identifies collaborative approaches from the literature but the relevance to establishing or improving an interdisciplinary team to address an organizational issue is unclear or insufficiently explained. Describes collaborative approaches from the literature that could be relevant in establishing or improving an interdisciplinary team to address an organizational issue. Describes collaborative approaches from the literature that could be relevant in establishing or improving an interdisciplinary team to address an organizational issue. Notes which sources seem most credible or relevant to the specific organizational issue.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling. Does not organize content for ideas. Lacks logical flow and smooth transitions. Organizes content with some logical flow and smooth transitions. Contains errors in grammar/punctuation, word choice, and spelling. Organizes content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling. Organizes content with a clear purpose. Content flows logically with smooth transitions using coherent paragraphs, correct grammar/punctuation, word choice, and free of spelling errors.
Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format. Does not apply APA formatting to headings, in-text citations, and references. Does not use quotes or paraphrase correctly. Applies APA formatting to in-text citations, headings and references incorrectly and/or inconsistently, detracting noticeable from the content. Inconsistently uses headings, quotes and/or paraphrasing. Applies APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format. Exhibits strict and flawless adherence to APA formatting of headings, in-text citations, and references. Quotes and paraphrases correctly.

 

 

Changes in Medical Education

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Changes in Medical Education

Assessment 2 Instructions: Changes in Medical Education

Top of Form

Bottom of Form

  • PRINT
  • Write a 3-4 page paper to analyze the scope of change in medical education from the 1800s to today, the apprenticeship and academic models, and the importance of understanding the history in order to help improve medical education in the future. Changes in Medical Education

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Jake is seeking a position in health care recruiting and human capital management. He is examining the many different professional roles that make up the health care workforce in the United States. He finds that clinical and administrative roles are significantly different today than those in the 18th, 19th, and early 20th centuries. Physicians, nurses, technologists, and many of the administrative positions today require state licensure, periodic revalidation, certifications, recertification, or registration in order to practice their profession. 

Throughout the ages there have been many landmark studies, reports, and events that have changed the course of history in medicine and medical education. The Flexner Report (1910) reformed medical education and brought it to where it is today (Young & Kroth, 2018). This report was the catalyst that pushed for legislation requiring physicians to be licensed. The report called for formalizing medical education and increasing the length of time in structured, formal medical programs. This report has influenced medical education and licensing for all of the many different types of clinical, technical, and administrative health care disciplines of today.

For your assessment, think about the evolution of health care education and its effect on the various clinical and administrative roles. Where does provider credentialing fit into the scheme of things, and why is it so important in health care today? How does today’s fellowship training experience compare with the previous apprenticeship training experience? What are the innovative technological advancements that have elevated the health care professions and the clinics and hospitals that these professionals work in today? 

Reference

Young, K. M., & Kroth, P. J. (2018). Sultz & Young’s health care USA: Understanding its organization and delivery (9th ed.). Jones & Bartlett Learning.

Scenario

Imagine you are a medical apprentice in the 1800s. Envision your medical training during this era under the apprenticeship model. Jump to the 1960s and envision your training under the academic model. Finally, think of what your medical school training might look like today.

Of particular interest for today’s training are the many technology innovations for learning in medical schools, including augmented reality (AR), virtual reality (VR), robotic-assisted surgery, and minimally or noninvasive procedure technologies. Today’s training features remote patient monitoring (RPM) and telemedicine through a virtual model of care (VMC), as well as learning to use the human genome for more accurate diagnosing and patient-specific treatments.

Instructions

Write a 3–4 page paper to analyze the scope of change in medical education from the 1800s to today, the apprenticeship and academic models, and the importance of understanding the history in order to help improve medical education in the future.

Do the following:

  1. The textbook is suggested as the most efficient resource for this assessment, or use other resources from those provided with this assessment. You may also use resources you find on your own from the History of Health Care Researchtab in the Health Care Administration Undergraduate Library Research Guide to research the history of medical education from the 1800s, 1960s, early 2000s, and today.
    • You will need to include four references in your paper, one of which can be your textbook.
    • Use the course resources provided for the remaining references, or locate your own resources.
  2. Write an introduction to your paper using the Changes in Medical Education Template [DOCX].
    • Include a brief explanation of the purpose of the paper and its main ideas.
    • Refer to the Writing Supportpage on Campus for resources to help you as you write and revise your paper.
  3. In The Changing Scope of Medical Educationsection of the assessment template, analyze the scope of the changes in medical education from the 1800s to today.
    • How widespread are the newer technologies impacting medical training?
    • Have there been mandated changes or have there been cultural changes that have impacted medical education?
  4. In the Apprenticeship Model vs. Academic Modelsection of the assessment template, compare and contrast the apprenticeship and academic models of medical education in the 1800s, 1960s, 2000s, and today.
    • Describe the apprenticeship model and the academic model.
    • Compare and contrast the similarities and differences in their features.
    • Analyze how the models have evolved over time and the impact the evolution of these models has had on the quality of patient care.
  5. In the Importance of Understanding History of Medicinesection of the assessment template, explain the importance of understanding the history of medical education in order to help improve medical education in the future.
  6. Write a conclusion to your paper in which you summarize the main themes you addressed.
  7. Cite all the resources you used in your paper in APA format. Refer to Evidence and APAin the Capella Writing Center for help with using APA style.

Additional Requirements

  • Your paper should be 3–4 pages, in addition to the title page and references page.
  • Double space and use Times New Roman, 12-point font, as is provided in the template.
  • Use a minimum of four resources; you may include the textbook and other course resources.
  • Respond to all parts of the template, using the headings provided.
  • Support all points with credible evidence, in the form of APA citations.
  • Include a references page in APA format with appropriate citations.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

  • Competency 3: Analyze the development of medical education in the United States.
    • Analyze the scope of change in medical education from the 1800s to today.
    • Compare and contrast the apprenticeship model and the academic model of medical education.
    • Analyze the impact of the evolution of the models on patient care.
    • Analyze why it is important to understand the history of medicine in order to improve medical education.
  • Competency 4: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others.
    • Articulates meaning relevant to the main topic, scope, and purpose of the prompt.
    • Applies APA formatting to in-text citations and references.

 

 

Changes in Medical Education Scoring Guide

CRITERIA NON-PERFORMANCE BASIC PROFICIENT DISTINGUISHED
Analyze the scope of change in medical education from the 1800s to today. Does not describe developments in medical education since the 1800s. Describes some developments in medical education since the 1800s. Analyzes the scope of change in medical education since the 1800s. Analyzes the scope of change in medical education since the 1800s. Provides specific examples and ramifications of their impact.
Compare and contrast the apprenticeship model and the academic model of medical education. Does not compare and contrast the apprenticeship model and the academic model of medical education. Describes the apprenticeship model and the academic model of medical education. Compares and contrasts the apprenticeship model and the academic model of medical education. Compares and contrasts the apprenticeship model and the academic model of medical education. Provides specific examples.
Analyze the impact of the evolution of the models on patient care. Does not describe the evolution of the models on patient care. Addresses the evolution of the models but does not analyze the impact on patient care. Analyzes the impact of the evolution of the models on patient care. Analyzes the impact of the evolution of the models on patient care. Provides examples of impacted patient care quality or outcomes.
Analyze why it is important to understand the history of medicine in order to improve medical education. Does not address why it is important to understand the history of medicine in order to improve medical education. Describes but does not analyze why it is important to understand the history of medicine in order to improve medical education. Analyzes why it is important to understand the history of medicine in order to improve medical education. Analyzes why it is important to understand the history of medicine in order to improve medical education. Supports the analysis with references to the professional literature.
Articulates meaning relevant to the main topic, scope, and purpose of the prompt. Writing is unrelated to the assessment prompt. Addresses a specific topic with unclear intent or insufficient depth. Articulates meaning relevant to the main topic, scope, and purpose of the prompt. Articulates a focused response to the assessment prompt and demonstrates a thorough understanding of the main topic, scope, and purpose.
Applies APA formatting to in-text citations and references. Does not apply APA style and formatting to scholarly writing. Applies APA formatting to in-text citations and references incorrectly and/or inconsistently, detracting noticeably from good scholarship. Applies APA formatting to in-text citations and references. Exhibits strict and nearly flawless adherence to APA formatting of in-text citations and references.

 

 

Historical Health Care Trend Analysis

/in /by

Historical Health Care Trend Analysis

Assessment 3 Instructions: Historical Health Care Trend Analysis

Top of Form

Bottom of Form

  • PRINT
  • Write a 2-3 page trend analysis paper to describe health care regulations and medical practice evolutionary changes for access, quality, and cost, including the significant milestone events for different time periods.

    ORDER A PLAGIARISM FREE PAPER NOW

Moana is a newly appointed quality reporting analyst for a Northeast Accountable Care Organization (ACO). Her director tells her that the U.S. health care system is going through a quality revolution. The drivers of this movement are years of proposed, failed, and enacted legislation; many regulatory agencies lobbying for change; and the myriad of quality initiatives implemented before and after the Affordable Care Act. Other influences in this trend are Medicare, Medicaid, employer groups, and the managed care markets’ drive to improve quality and reduce costs. The beneficiaries of these plans—patients—want transparency of their services in regard to quality, safety, and cost. Historical Health Care Trend Analysis

To achieve these desired health service outcomes, private and public health systems work in tandem to reduce the burden of disease and increase quality, while managing costs. They do this through programs such as Vaccines for Children (VFC) and Women, Infants, and Children (WIC), the Substance Abuse and Mental Health Services Administration (SAMHSA), Healthy People (1990–2030), Program of All-inclusive Care for the Elderly (PACE), and many more. Moana’s director shares with her that all of these private–public health programs and initiatives, in addition to the significant advancements in medical education, research, and technologies, have led to one of the most highly regulated industries in the United States and the world today.

In this assessment, you will review the private and public health legislation, regulatory agencies, and quality initiatives that have catapulted the United States into the quality revolution that we are experiencing today. As this quality revolution continues, health care professionals can expect to see more innovations contributing to individual patient and population health quality initiatives, with many more regulations to come.

Scenario

You are a health care educator for a large integrated accountable care organization (ACO). You are tasked to work with a group of hospital executives to identify milestone events for three eras, the 1800s, 1900s, and 2000s, and identify trends from those events that impacted the health care industry. The trend analysis will consist of three critical measures: access, quality, and costs. Milestone events and trends identified for these three measures over time should include legislation, regulatory agencies, and quality initiatives in the various time periods. The final paper will be used in an annual strategic planning session attended by the ACO and hospital executives to demonstrate how the quality movement has evolved into a quality revolution.

Instructions

Write a 2–3 page paper in which you explain and analyze health care regulations and medical practice evolutionary changes for access, quality, and cost, including the significant milestone events from different time periods.

Complete the following:

  1. Study the Health Care Quality Evolution Milestone Events Chart [DOCX]to review the key regulatory or quality initiative events relative to the 1800s, the 1900s, and the 2000s.
  2. The textbook is suggested as the most efficient resource for this assessment, or use at least two other resources from those provided with this assessment. You may also use resources you find on your own from the History of Health Care Researchtab in the Health Care Administration Undergraduate Library Research Guide to research for the Trend Analysis Table: Evolution of Access, Quality, and Cost in Health Care table in the appendix of the Historical Health Care Trend Analysis Template [DOCX].
    • You are required to reference a total of three scholarly sources in your paper.
    • Be sure to cite these references within the body of your paper correctly using APA style citations. Refer to Evidence and APAin the Capella Writing Center for help with using APA style.
  3. Complete the Trend Analysis Table: Evolution of Access, Quality, and Cost in Health Carein the appendix for the assessment template.
    • For each time period, select 2 milestone events or regulations from the Health Care Quality Evolution Milestone Events Chart [DOCX]that have affected each topic: access to health care, quality of health care, and cost of health care.
    • There should be a total of 18 milestone events or regulations in the completed table.
    • Include bullet points with notes that describe each event or regulation and how it impacted access, quality, or cost.
  4. Write an introduction for the paper using the Historical Health Care Trend Analysis Template [DOCX].
    • Provide a brief explanation of the purpose of this historical trend analysis and how it might be used in your work as a health administrator (1 paragraph).
    • Where appropriate, reference significant health care milestones, regulations, and measures for access, quality, and cost.
    • Refer to the Writing Supportpage on Campus for resources to help you as you write and revise your paper.
  5. Use the Trend Analysis Table: Evolution of Access, Quality, and Cost in Health Care table to write the body of your paper.
    • Complete the Trends and Regulationssection in the assessment template.
      • Provide a brief description of the key measures of health care services, which are access, quality, and cost (1–2 paragraphs).
      • In the Health Care Accesssubsection, explain the significant trends and regulatory milestones associated with access to health care over the recent eras (1–2 paragraphs).
        • What U.S. legislation, regulatory agencies, and quality initiatives from the 1800s, 1900s, and 2000s have influenced access to health care services in the United States?
        • What does your milestone trend analysis reveal for access to care?
        • Include citations and references to specific regulations, events, or agencies.
      • In the Health Care Qualitysubsection, explain the significant trends and regulatory milestones associated with health care quality over the recent eras (1–2 paragraphs).
        • What U.S. legislation, regulatory agencies, and quality initiatives from the 1800s, 1900s, and 2000s have influenced care quality in health care services in the United States?
        • What does your trend analysis reveal for care quality?
        • Include citations and references to specific regulations, events, or agencies.
      • In the Health Care Costsubsection, explain the significant trends and regulatory milestones associated with access to health care costs over the recent eras (1–2 paragraphs).
        • What U.S. legislation, regulatory agencies, and quality initiatives from the 1800s, 1900s, and 2000s have affected health care costs for medical services?
        • What does your trend analysis reveal for medical service costs?
        • Include citations and references to specific regulations, events, or agencies.
      • Complete the Trend Analysissection of the assessment template (1–2 paragraphs).
        • Analyze the trends and regulations in health care access, quality, and cost to draw conclusions about the evolution of health care regulations and practice throughout the recent eras.
        • Describe professional experiences or examples to illustrate the trends.
        • Include citations and references to specific regulations, events, or agencies.
  1. Write the conclusion for the paper (1 paragraph).
    • Briefly restate the trends revealed for health care access, quality, and cost.
    • Draw a conclusion about how the milestones, regulations, and changes have improved, been neutral, or inhibited progress of the U.S. health care system.
    • Summarize clear and concise conclusions of your trend analysis.

Additional Requirements

  • Your paper should be 2–3 pages, in addition to the title page, appendix, and references page.
  • Double space your paper, and use Times New Roman, 12-point font, as indicated in the assessment template.
  • Use a minimum of three resources. This may include your textbook and other course resources.
  • Complete all parts of the assessment template, using the headings provided in the template.
  • Support all points with credible evidence, in the form of APA citations.
  • Include a references page in APA format with appropriate citations.
  • Complete the Trend Analysis Table: Evolution of Access, Quality, and Cost in Health Carein the appendix of the assessment template.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

  • Competency 1: Analyze trends in the U.S. health care system from a historical perspective.
    • Identify health care legislative, regulatory agency, and quality initiative events in a trend analysis table of different eras.
  • Competency 2: Explain the development of health regulation and the evolution of medical practice.
    • Explain the significant trends and regulatory milestones associated with access to health care over the recent eras.
    • Explain the significant trends and regulatory milestones associated with health care quality over the recent eras.
    • Explain the significant trends and regulatory milestones associated with health care costs over the recent eras.
    • Analyze the trends and regulations in health care access, quality, and cost to draw conclusions about the evolution of health care regulations and practice throughout the recent eras.
  • Competency 4: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others.
    • Appropriately addresses all components of the assessment prompt, using the assessment description to structure text.
    • Apply APA formatting to in-text citations and references.

 

Historical Health Care Trend Analysis Scoring Guide

CRITERIA NON-PERFORMANCE BASIC PROFICIENT DISTINGUISHED
Identify health care legislative, regulatory agency, and quality initiative events in a trend analysis table of different eras. Does not identify health care legislative, regulatory agency, and quality initiative events in a trend analysis table of different eras. Identifies some health care legislative, regulatory agency, and quality initiative events in a trend analysis table of different eras but does not include the most significant events for each topic. Identifies health care legislative, regulatory agency, and quality initiative events in a trend analysis table of different eras. Describes the most significant health care legislative, regulatory agency, and quality initiative events in a trend analysis table of different eras, and all of the events per topic are related or follow a consistent theme.
Explain the significant trends and regulatory milestones associated with access to health care over the recent eras. Does not explain the significant trends and regulatory milestones associated with access to health care over the recent eras. Explains part of a trend or regulatory milestone associated with access to health care or does not select the most significant events that relate to the topic consistently across the eras. Explains the significant trends and regulatory milestones associated with access to health care over the recent eras. Explains the most significant trends accurately and in context using examples of the access to health care regulatory milestones from the appropriate time frames.
Explain the significant trends and regulatory milestones associated with health care quality over the recent eras. Does not explain the trends and regulatory milestones associated with health care quality over the recent eras. Explains part of a trend or regulatory milestone associated with health care quality or does not select the most significant events that relate to the topic consistently across the eras. Explains the significant trends and regulatory milestones associated with health care quality over the recent eras. Explains the most significant trends accurately and in context using examples of the health care quality regulatory milestones from the appropriate time frames.
Explain the significant trends and regulatory milestones associated with health care costs over the recent eras. Does not explain the trends and regulatory milestones associated with health care costs over the recent eras. Explains part of a trend or regulatory milestone associated with health care costs or does not select the most significant events that relate to the topic consistently across the eras. Explains the significant trends and regulatory milestones associated with health care costs over the recent eras. Explains the most significant trends accurately and in context using examples of the health care quality regulatory milestones from the appropriate time frames.
Analyze the trends and regulations in health care access, quality, and cost to draw conclusions about the evolution of health care regulations and practice throughout the recent eras. Does not analyze the trends and regulations in health care access, quality, and cost to draw conclusions about the evolution of health care regulations and practice throughout the recent eras. Describes some trends and regulations in health care access, quality, and cost and draws at least one conclusion about the evolution of health care regulations and/or practice throughout the recent eras, but does not provide a thorough analysis of both regulations and practice. Analyzes the trends and regulations in health care access, quality, and cost to draw conclusions about the evolution of health care regulations and practice throughout the recent eras. Analyzes the trends and regulations in health care access, quality, and cost to draw professional conclusions about the evolution of health care regulations and practice throughout the recent eras, supported by examples and references to the most appropriate milestones and professional literature.
Appropriately addresses all components of the assessment prompt, using the assessment description to structure text. Does not address the assessment prompt. Writing lacks a clear purpose or message that inhibits effective communication with the intended audience. Appropriately addresses all components of the assessment prompt, using the assessment description to structure text. Appropriately addresses all components of the assessment prompt and uses the prompt to guide organization. Additionally, shares information relevant to all assessment components at a level that communicates clear meaning.
Apply APA formatting to in-text citations and references. Does not apply APA formatting to in-text citations and references. Applies APA formatting to in-text citations and references incorrectly and/or inconsistently, detracting noticeably from good scholarship. Applies APA formatting to in-text citations and references. Exhibits strict and nearly flawless adherence to APA formatting of in-text citations and references.

 

Long-Term Care and Mental Health Services

  • Young, K. M., & Kroth, P. J. (2018). Sultz & Young’s health care USA: Understanding its organization and delivery(9th ed.). Jones & Bartlett Learning. Available in the courseroom via the VitalSource Bookshelf link.
    • Chapter 9, “Long-Term Care,” pages 245–274.
    • Chapter 10, “Behavioral Health Services,” pages 277–299.
  • Ernst, W. (2018). The role of work in psychiatry: Historical reflections.Indian Journal of Psychiatry, 60(6), S248–S252.
    • This article outlines the history of psychiatry from 1751 to today and the changes within medical, social, and political contexts.
  • Nadash, P. (2020). The evolution of long-term care programs comment on “Financing long-term care: Lessons from Japan.”International Journal of Health Policy and Management, 9(1), 42–44.
    • This article reflects on lessons learned regarding social insurance, caregivers, and the financing of long-term care from Japan and Germany.
  • Kaiser Family Foundation. (2015, August 31). Long-term care in the United States: A timeline.https://www.kff.org/medicaid/timeline/long-term-care-in-the-united-states-a-timeline/
    • This website shows a timeline of 1935–2015 and the evolution, milestones, legislation, and funding of long-term care.
  • National Institute of Mental Health. (2021). Important events in NIMH history.The NIH Almanac. https://www.nih.gov/about-nih/what-we-do/nih-almanac/national-institute-mental-health-nimh#events
    • This website shows a timeline of 1946–2015 and the evolution, milestones, and advancements in mental health.

 

Health Care Quality

  • Young, K. M., & Kroth, P. J. (2018). Sultz & Young’s health care USA: Understanding its organization and delivery(9th ed.). Jones & Bartlett Learning. Available in the courseroom via the VitalSource Bookshelf link.
    • Chapter 11, “Public Health and the Role of Government in Health Care,” pages 301–349.
    • Chapter 13, “Future of Health Care,” pages 371–390.
  • Health Care Quality Evolution Milestone Events Chart [DOCX].
    • Study the events on this timeline to determine trends in access, quality, and cost of health care throughout history. You will use the milestones on this timeline to research and write your assessment.
  • Chan, D. C., Huynh, J., & Studdert, D. M. (2019). Accuracy of valuations of surgical procedures in the Medicare fee schedule.The New England Journal of Medicine, 380(16), 1546–1554.
    • This article explains resource-based relative value scale based on relative value units (RVUs). It outlines physician work RVUs, practice expense RVUs, and malpractice RVUs and discusses room for improvements in this system.
  • Devkaran, S., Patrick N O’Farrell, Ellahham, S., & Arcangel, R. (2019). Impact of repeated hospital accreditation surveys on quality and reliability, an 8-year interrupted time series analysis.BMJ Open, 9(2).
    • This is an eight-year accreditation study of hospitals that demonstrate improved quality measure outcomes.
  • Speer, M., McCullough, J. M., Fielding, J. E., Faustino, E., & Teutsch, S. M. (2020). Excess medical care spending: The categories, magnitude, and opportunity costs of wasteful spending in the United States.American Journal of Public Health, 110(12), 1743–1748.
    • This resource contains several reputable landmark reports of hundreds of billions of dollars wasted in the United States on medical care every year with no improvements of health outcomes. It discusses six categories: clinical inefficiencies, missed prevention opportunities, overuse, administrative waste, excessive prices, and fraud and abuse.
  • (n.d.). HEDIS and performance measurement.https://www.ncqa.org/hedis/
    • This website shows NCQA accreditation for managed care organizations (MCOs) and HEDIS quality reporting to demonstrate the MCO population health status.
  • The Joint Commission. (n.d.). Accreditation basics for beginners.https://www.jointcommission.org/accreditation-and-certification/health-care-settings/home-care/home-care-on-demand-webinars/home-care-accreditation-basics-for-beginners/
    • This website and video presentation show how accreditation is performed from beginning to end, including process, resources, and costs.

 

Historical Health Care Trend Analysis

/in /by

Historical Health Care Trend Analysis

Assessment 3 Instructions: Historical Health Care Trend Analysis

Top of Form

Bottom of Form

  • PRINT
  • Write a 2-3 page trend analysis paper to describe health care regulations and medical practice evolutionary changes for access, quality, and cost, including the significant milestone events for different time periods.

Moana is a newly appointed quality reporting analyst for a Northeast Accountable Care Organization (ACO). Her director tells her that the U.S. health care system is going through a quality revolution. The drivers of this movement are years of proposed, failed, and enacted legislation; many regulatory agencies lobbying for change; and the myriad of quality initiatives implemented before and after the Affordable Care Act. Other influences in this trend are Medicare, Medicaid, employer groups, and the managed care markets’ drive to improve quality and reduce costs. The beneficiaries of these plans—patients—want transparency of their services in regard to quality, safety, and cost. Historical Health Care Trend Analysis

ORDER A PLAGIARISM FREE PAPER NOW

To achieve these desired health service outcomes, private and public health systems work in tandem to reduce the burden of disease and increase quality, while managing costs. They do this through programs such as Vaccines for Children (VFC) and Women, Infants, and Children (WIC), the Substance Abuse and Mental Health Services Administration (SAMHSA), Healthy People (1990–2030), Program of All-inclusive Care for the Elderly (PACE), and many more. Moana’s director shares with her that all of these private–public health programs and initiatives, in addition to the significant advancements in medical education, research, and technologies, have led to one of the most highly regulated industries in the United States and the world today.

In this assessment, you will review the private and public health legislation, regulatory agencies, and quality initiatives that have catapulted the United States into the quality revolution that we are experiencing today. As this quality revolution continues, health care professionals can expect to see more innovations contributing to individual patient and population health quality initiatives, with many more regulations to come. 

Scenario

You are a health care educator for a large integrated accountable care organization (ACO). You are tasked to work with a group of hospital executives to identify milestone events for three eras, the 1800s, 1900s, and 2000s, and identify trends from those events that impacted the health care industry. The trend analysis will consist of three critical measures: access, quality, and costs. Milestone events and trends identified for these three measures over time should include legislation, regulatory agencies, and quality initiatives in the various time periods. The final paper will be used in an annual strategic planning session attended by the ACO and hospital executives to demonstrate how the quality movement has evolved into a quality revolution.

Instructions

Write a 2–3 page paper in which you explain and analyze health care regulations and medical practice evolutionary changes for access, quality, and cost, including the significant milestone events from different time periods.

Complete the following:

  1. Study the Health Care Quality Evolution Milestone Events Chart [DOCX]to review the key regulatory or quality initiative events relative to the 1800s, the 1900s, and the 2000s.
  2. The textbook is suggested as the most efficient resource for this assessment, or use at least two other resources from those provided with this assessment. You may also use resources you find on your own from the History of Health Care Researchtab in the Health Care Administration Undergraduate Library Research Guide to research for the Trend Analysis Table: Evolution of Access, Quality, and Cost in Health Care table in the appendix of the Historical Health Care Trend Analysis Template [DOCX].
    • You are required to reference a total of three scholarly sources in your paper.
    • Be sure to cite these references within the body of your paper correctly using APA style citations. Refer to Evidence and APAin the Capella Writing Center for help with using APA style.
  3. Complete the Trend Analysis Table: Evolution of Access, Quality, and Cost in Health Carein the appendix for the assessment template.
    • For each time period, select 2 milestone events or regulations from the Health Care Quality Evolution Milestone Events Chart [DOCX]that have affected each topic: access to health care, quality of health care, and cost of health care.
    • There should be a total of 18 milestone events or regulations in the completed table.
    • Include bullet points with notes that describe each event or regulation and how it impacted access, quality, or cost.
  4. Write an introduction for the paper using the Historical Health Care Trend Analysis Template [DOCX].
    • Provide a brief explanation of the purpose of this historical trend analysis and how it might be used in your work as a health administrator (1 paragraph).
    • Where appropriate, reference significant health care milestones, regulations, and measures for access, quality, and cost.
    • Refer to the Writing Supportpage on Campus for resources to help you as you write and revise your paper.
  5. Use the Trend Analysis Table: Evolution of Access, Quality, and Cost in Health Care table to write the body of your paper.
    • Complete the Trends and Regulationssection in the assessment template.
      • Provide a brief description of the key measures of health care services, which are access, quality, and cost (1–2 paragraphs).
      • In the Health Care Accesssubsection, explain the significant trends and regulatory milestones associated with access to health care over the recent eras (1–2 paragraphs).
        • What U.S. legislation, regulatory agencies, and quality initiatives from the 1800s, 1900s, and 2000s have influenced access to health care services in the United States?
        • What does your milestone trend analysis reveal for access to care?
        • Include citations and references to specific regulations, events, or agencies.
      • In the Health Care Qualitysubsection, explain the significant trends and regulatory milestones associated with health care quality over the recent eras (1–2 paragraphs).
        • What U.S. legislation, regulatory agencies, and quality initiatives from the 1800s, 1900s, and 2000s have influenced care quality in health care services in the United States?
        • What does your trend analysis reveal for care quality?
        • Include citations and references to specific regulations, events, or agencies.
      • In the Health Care Costsubsection, explain the significant trends and regulatory milestones associated with access to health care costs over the recent eras (1–2 paragraphs).
        • What U.S. legislation, regulatory agencies, and quality initiatives from the 1800s, 1900s, and 2000s have affected health care costs for medical services?
        • What does your trend analysis reveal for medical service costs?
        • Include citations and references to specific regulations, events, or agencies.
      • Complete the Trend Analysissection of the assessment template (1–2 paragraphs).
        • Analyze the trends and regulations in health care access, quality, and cost to draw conclusions about the evolution of health care regulations and practice throughout the recent eras.
        • Describe professional experiences or examples to illustrate the trends.
        • Include citations and references to specific regulations, events, or agencies.
  1. Write the conclusion for the paper (1 paragraph).
    • Briefly restate the trends revealed for health care access, quality, and cost.
    • Draw a conclusion about how the milestones, regulations, and changes have improved, been neutral, or inhibited progress of the U.S. health care system.
    • Summarize clear and concise conclusions of your trend analysis.

Additional Requirements

  • Your paper should be 2–3 pages, in addition to the title page, appendix, and references page.
  • Double space your paper, and use Times New Roman, 12-point font, as indicated in the assessment template.
  • Use a minimum of three resources. This may include your textbook and other course resources.
  • Complete all parts of the assessment template, using the headings provided in the template.
  • Support all points with credible evidence, in the form of APA citations.
  • Include a references page in APA format with appropriate citations.
  • Complete the Trend Analysis Table: Evolution of Access, Quality, and Cost in Health Carein the appendix of the assessment template.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

  • Competency 1: Analyze trends in the U.S. health care system from a historical perspective.
    • Identify health care legislative, regulatory agency, and quality initiative events in a trend analysis table of different eras.
  • Competency 2: Explain the development of health regulation and the evolution of medical practice.
    • Explain the significant trends and regulatory milestones associated with access to health care over the recent eras.
    • Explain the significant trends and regulatory milestones associated with health care quality over the recent eras.
    • Explain the significant trends and regulatory milestones associated with health care costs over the recent eras.
    • Analyze the trends and regulations in health care access, quality, and cost to draw conclusions about the evolution of health care regulations and practice throughout the recent eras.
  • Competency 4: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others.
    • Appropriately addresses all components of the assessment prompt, using the assessment description to structure text.
    • Apply APA formatting to in-text citations and references.

 

Historical Health Care Trend Analysis Scoring Guide

CRITERIA NON-PERFORMANCE BASIC PROFICIENT DISTINGUISHED
Identify health care legislative, regulatory agency, and quality initiative events in a trend analysis table of different eras. Does not identify health care legislative, regulatory agency, and quality initiative events in a trend analysis table of different eras. Identifies some health care legislative, regulatory agency, and quality initiative events in a trend analysis table of different eras but does not include the most significant events for each topic. Identifies health care legislative, regulatory agency, and quality initiative events in a trend analysis table of different eras. Describes the most significant health care legislative, regulatory agency, and quality initiative events in a trend analysis table of different eras, and all of the events per topic are related or follow a consistent theme.
Explain the significant trends and regulatory milestones associated with access to health care over the recent eras. Does not explain the significant trends and regulatory milestones associated with access to health care over the recent eras. Explains part of a trend or regulatory milestone associated with access to health care or does not select the most significant events that relate to the topic consistently across the eras. Explains the significant trends and regulatory milestones associated with access to health care over the recent eras. Explains the most significant trends accurately and in context using examples of the access to health care regulatory milestones from the appropriate time frames.
Explain the significant trends and regulatory milestones associated with health care quality over the recent eras. Does not explain the trends and regulatory milestones associated with health care quality over the recent eras. Explains part of a trend or regulatory milestone associated with health care quality or does not select the most significant events that relate to the topic consistently across the eras. Explains the significant trends and regulatory milestones associated with health care quality over the recent eras. Explains the most significant trends accurately and in context using examples of the health care quality regulatory milestones from the appropriate time frames.
Explain the significant trends and regulatory milestones associated with health care costs over the recent eras. Does not explain the trends and regulatory milestones associated with health care costs over the recent eras. Explains part of a trend or regulatory milestone associated with health care costs or does not select the most significant events that relate to the topic consistently across the eras. Explains the significant trends and regulatory milestones associated with health care costs over the recent eras. Explains the most significant trends accurately and in context using examples of the health care quality regulatory milestones from the appropriate time frames.
Analyze the trends and regulations in health care access, quality, and cost to draw conclusions about the evolution of health care regulations and practice throughout the recent eras. Does not analyze the trends and regulations in health care access, quality, and cost to draw conclusions about the evolution of health care regulations and practice throughout the recent eras. Describes some trends and regulations in health care access, quality, and cost and draws at least one conclusion about the evolution of health care regulations and/or practice throughout the recent eras, but does not provide a thorough analysis of both regulations and practice. Analyzes the trends and regulations in health care access, quality, and cost to draw conclusions about the evolution of health care regulations and practice throughout the recent eras. Analyzes the trends and regulations in health care access, quality, and cost to draw professional conclusions about the evolution of health care regulations and practice throughout the recent eras, supported by examples and references to the most appropriate milestones and professional literature.
Appropriately addresses all components of the assessment prompt, using the assessment description to structure text. Does not address the assessment prompt. Writing lacks a clear purpose or message that inhibits effective communication with the intended audience. Appropriately addresses all components of the assessment prompt, using the assessment description to structure text. Appropriately addresses all components of the assessment prompt and uses the prompt to guide organization. Additionally, shares information relevant to all assessment components at a level that communicates clear meaning.
Apply APA formatting to in-text citations and references. Does not apply APA formatting to in-text citations and references. Applies APA formatting to in-text citations and references incorrectly and/or inconsistently, detracting noticeably from good scholarship. Applies APA formatting to in-text citations and references. Exhibits strict and nearly flawless adherence to APA formatting of in-text citations and references.

 

Long-Term Care and Mental Health Services

  • Young, K. M., & Kroth, P. J. (2018). Sultz & Young’s health care USA: Understanding its organization and delivery(9th ed.). Jones & Bartlett Learning. Available in the courseroom via the VitalSource Bookshelf link.
    • Chapter 9, “Long-Term Care,” pages 245–274.
    • Chapter 10, “Behavioral Health Services,” pages 277–299.
  • Ernst, W. (2018). The role of work in psychiatry: Historical reflections.Indian Journal of Psychiatry, 60(6), S248–S252.
    • This article outlines the history of psychiatry from 1751 to today and the changes within medical, social, and political contexts.
  • Nadash, P. (2020). The evolution of long-term care programs comment on “Financing long-term care: Lessons from Japan.”International Journal of Health Policy and Management, 9(1), 42–44.
    • This article reflects on lessons learned regarding social insurance, caregivers, and the financing of long-term care from Japan and Germany.
  • Kaiser Family Foundation. (2015, August 31). Long-term care in the United States: A timeline.https://www.kff.org/medicaid/timeline/long-term-care-in-the-united-states-a-timeline/
    • This website shows a timeline of 1935–2015 and the evolution, milestones, legislation, and funding of long-term care.
  • National Institute of Mental Health. (2021). Important events in NIMH history.The NIH Almanac. https://www.nih.gov/about-nih/what-we-do/nih-almanac/national-institute-mental-health-nimh#events
    • This website shows a timeline of 1946–2015 and the evolution, milestones, and advancements in mental health.

 

Health Care Quality

  • Young, K. M., & Kroth, P. J. (2018). Sultz & Young’s health care USA: Understanding its organization and delivery(9th ed.). Jones & Bartlett Learning. Available in the courseroom via the VitalSource Bookshelf link.
    • Chapter 11, “Public Health and the Role of Government in Health Care,” pages 301–349.
    • Chapter 13, “Future of Health Care,” pages 371–390.
  • Health Care Quality Evolution Milestone Events Chart [DOCX].
    • Study the events on this timeline to determine trends in access, quality, and cost of health care throughout history. You will use the milestones on this timeline to research and write your assessment.
  • Chan, D. C., Huynh, J., & Studdert, D. M. (2019). Accuracy of valuations of surgical procedures in the Medicare fee schedule.The New England Journal of Medicine, 380(16), 1546–1554.
    • This article explains resource-based relative value scale based on relative value units (RVUs). It outlines physician work RVUs, practice expense RVUs, and malpractice RVUs and discusses room for improvements in this system.
  • Devkaran, S., Patrick N O’Farrell, Ellahham, S., & Arcangel, R. (2019). Impact of repeated hospital accreditation surveys on quality and reliability, an 8-year interrupted time series analysis.BMJ Open, 9(2).
    • This is an eight-year accreditation study of hospitals that demonstrate improved quality measure outcomes.
  • Speer, M., McCullough, J. M., Fielding, J. E., Faustino, E., & Teutsch, S. M. (2020). Excess medical care spending: The categories, magnitude, and opportunity costs of wasteful spending in the United States.American Journal of Public Health, 110(12), 1743–1748.
    • This resource contains several reputable landmark reports of hundreds of billions of dollars wasted in the United States on medical care every year with no improvements of health outcomes. It discusses six categories: clinical inefficiencies, missed prevention opportunities, overuse, administrative waste, excessive prices, and fraud and abuse.
  • (n.d.). HEDIS and performance measurement.https://www.ncqa.org/hedis/
    • This website shows NCQA accreditation for managed care organizations (MCOs) and HEDIS quality reporting to demonstrate the MCO population health status.
  • The Joint Commission. (n.d.). Accreditation basics for beginners.https://www.jointcommission.org/accreditation-and-certification/health-care-settings/home-care/home-care-on-demand-webinars/home-care-accreditation-basics-for-beginners/
    • This website and video presentation show how accreditation is performed from beginning to end, including process, resources, and costs.

 

Health Care Quality Evolution Milestone Events Chart

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Health Care Quality Evolution Milestone Events Chart

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Health Care Quality Evolution Milestone Events Chart

Healthcare Legislation, Regulatory Agencies, and Quality Initiatives Milestone Description
1)     1791 Regulating Healthcare States were given the right to regulate health and formally began licensing physicians (Chaudhry, 2010). Health Care Quality Evolution Milestone Events Chart
2)     1800 State medical boards State medical boards license, discipline, and regulate physicians and other health care professionals to protect the public (Truex, 2014).
3)     1850 First health insurance policy The Franklin Health Assurance Company of Massachusetts was the first commercial insurance company in the U.S. to provide private health care coverage benefits for injuries not resulting in death (Scofea, 1994).
4)     1862 U.S. Army Medical Department and the United States Sanitary Commission formed Post-Civil War, new health-related agencies, hospitals, and medical research and care implemented to care for the post-Civil War injured and increase population health awareness (Reilly, 2016).
5)     1886 U.S. Army established the Hospital Corps The first U.S. data repository to collect medical data. This was implemented by the Surgeon General’s Office and the Library of the Surgeon General (Weedn, 2020).
6)     1900 Self-pay is the primary source of payment for healthcare services Most Americans continued to pay their own health care expenses, which often meant either uncompensated charity care or no care. Hospitals were voluntary institutions that were privately supported (University of Pennsylvania School of Nursing, n.d.).
7)     1908 Workers’ compensation legislation President Theodore Roosevelt signed legislation to provide workers’ compensation (WC) for certain federal employees in unusually hazardous jobs (U.S. Department of Labor, n.d.).
8)     1915 American Association of Labor Legislation (AALL) The first universal access health insurance legislation. It would provide limited insurance benefits to working class, their dependents, and others who earned less than $1,200 a year. Although supported by the American Medical Association (AMA), it was never passed into law (Derickson, 2002).
9)     1916 The Federal Employees’ Compensation Act (FECA) Replaced the 1908 WC legislation to include civilian employees of the federal government. They were provided medical care, survivors’ benefits, and compensation for lost wages under FECA (U.S. Department of Labor, n.d.).
10)  1920 Introduction of prepaid health plans (direct contracting) Direct contracting between employers, local hospitals, and physicians for medical services was the first predetermined fee that was paid monthly or yearly basis. These prepaid health plans were the precursor of today’s managed care plans and capitation payments (Young & Kroth, 2018).
11)  1921 -1976 Indian Health Services (IHS) The Snyder Act of 1921 and the Indian Health Care Improvement Act (IHCIA) of 1976 created the legislative authority for Congress to provide funding to Native Americans for health care services, which is now known as the Indian Health Services (IHS) (Warne & Frizzell, 2014).
12)  1921 Sheppard-Towner Maternity and Infancy Act Legislation to reduce maternal and infant mortality. The Act was challenged and then said to be unconstitutional by the Supreme Court. Additionally, the Act was opposed by the American Medical Association. The act was not renewed and expired in 1929. (Moehling & Thomasson, 2012).
13)  1927 Workers’ Compensation Act Office of Workers’ Compensation Programs (OWCP) administers FECA as well as the Longshore and Harbor Workers’ Compensation Act of 1927 and the Black Lung Benefits Reform Act of 1977 (Young & Kroth, 2018).
14)  1929 Blue Cross (BC) Insurance Policy Baylor University, Dallas, TX, guaranteed schoolteachers 21 days of hospital care for $6 a year. Other groups of employees in Dallas joined, and in a short time period BC becomes hospital insurance nationwide (Young & Kroth, 2018).
15)  1930 Blue Shield (BS) Plans Blue Shield (BS) was founded to provide insurance to lumber and mining camps of the Pacific Northwest at the turn of the century. Employers paid fees to medical service bureaus, which were composed of groups of physicians. BS becomes physician insurance nationwide (Young & Kroth, 2018).
16)  1938 The Food, Drug, and Cosmetic Act was signed by President Franklin Delano Roosevelt Food, drug, and cosmetic safety implemented. The new law brought cosmetics and medical devices under control, and it required that drugs should be labeled with adequate directions for safe use (Young & Kroth, 2018; FDA, n.d.).
17)  1939 Wagner National Health Act (S.1620) The bill would have allowed the states to implement mandatory and universal health care but did not pass due to WWII (United States national health program: Wagner, bill, S. 1620, 1939).
18)  1946 Hill-Burton Act Provided federal grants for modernizing hospitals during the Great Depression and WWII (1929-1945). In return for federal funds, hospitals were required to provide services free or at reduced rates to patients unable to pay for care (Young & Kroth, 2018).
19)  1947 Taft-Hartley Act Amended the National Labor Relations Act of 1932, restoring a more balanced relationship between labor and management. An indirect result of Taft-Hartley was the creation of third-party administrators (TPAs), which administer health care plans and process claims, thus serving as a system of checks and balances for labor and management (Achermann, 2009).
20)  1948 International Classification of Disease (ICD), World Health Organization (WHO). Classification system used to collect diagnoses for statistical purposes. Originally used for mortality reporting but later and today used for morbidity reporting as well (Young & Kroth, 2018).
21)  1950 Major medical insurance Birth of the major medical insurance for catastrophic and prolonged illness, with deductibles and lifetime maximum benefit amounts (Young & Kroth, 2018).
22)  1951 The Joint Commission (JC): Facility Accreditation The Joint Commission does accreditation for hospitals and other medical facilities to ensure the facilities pass CMS, state and other inspections and ensure that services and facilities are safe and effective care of the highest quality and value (Young & Kroth, 2018).
23)  1956 Dependents’ Medical Care Act The Dependents’ Medical Care Act of 1956 was signed into law and provided health care to dependents of active military personnel (precursor to CHAMPVA 1973 and now TriCare 1988) (Young & Kroth, 2018).
24)  1966 Social Security Amendments of 1965 Medicare-Title XVIII insurance for Americans over the age of sixty-five (65). Medicaid-Title XIX a cost-sharing program between the federal and state governments to provide health care services to low-income Americans (Young & Kroth, 2018).
25)  1966 Current Procedural Terminology (CPT) The Current Procedural Terminology (CPT) codes were developed by the AMA in 1966 as a way to describe and track physician and other professional medical services. The CPT Code book is updated annually, and changes go into effect on January 1 of each new year (Dotson, 2013).
26)  1970 Controlled Substances Act (CSA); Drug Enforcement Agency (DEA): Controlled substances Controlled Substances Act (CSA) was created to improve the manufacturing, importation and exportation, distribution, and dispensing of controlled substances. Manufacturers, distributors, and dispensers of controlled substances must be registered with the Drug Enforcement Administration (DEA) (Gabay, 2013).
27)  1970 Occupational Safety and Health Administration Act OSHA) The Occupational Safety and Health Administration Act (OSHA) was designed to protect all employees against injuries from occupational hazards in the workplace (Young & Kroth, 2018).
28)  1972 Professional Standards Review Organizations (PSROs) Created as part of Title XI of the Social Security Amendments Act of 1972 were Professional Standards Review Organizations (PSROs), which were physician-controlled nonprofit organizations that contracted with CMS to provide for the review of hospital inpatient resource utilization, quality of care, and medical necessity. The PSROs were replaced with Peer Review Organizations (PROs), as a result of the Tax Equity and Fiscal Responsibility Act of 1982, or TEFRA (Young & Kroth, 2018).
29)  1973 Health Maintenance Organization Act The Health Maintenance Organization Assistance Act of 1973 authorized federal grants and loans to private organizations that wished to develop health maintenance organizations (HMOs), which are responsible for providing health care services to subscribers in a given geographic area for a fixed fee (Young & Kroth, 2018).
30)  1974 Employee Retirement Income Security Act of 1974 (ERISA) ERISA is a federal law that sets minimum standards for most voluntarily established retirement and health plans in private industry to provide protection for individuals in these plans. This law allows employers to be self-insured (Young & Kroth, 2018).
31)  1975 U.S. Nuclear Regulatory Commission (NRC) The NRC is a federal agency that ensures safe use of radioactive materials. They license and regulate the nation’s civilian use of radioactive materials to provide reasonable assurance of adequate safety for people and the environment. In health care this would include all diagnostic medical use, therapeutic medical use, and medical research use (United States Nuclear Regulatory Commission, 2020).
32)  1976 Food and Drug Administration (F.D.A.): Medical Equipment   FDA: Medical Device Amendments passed to ensure safety and effectiveness of medical devices, including diagnostic products (FDA, n.d.).
33)  1977 Health Care Financing Administration (HCFA) The DHHS combine health care financing and quality assurance programs into one agency, HCFA. Medicare and Medicaid programs were transferred to HCFA, which is now CMS (Young & Kroth, 2018).
34)  1980 American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF)             The AAAASF was established to standardize and improve the quality of health care in outpatient facilities. AAAASF accredits thousands of facilities worldwide including clinics, surgery centers, and state/federal health agencies, and patients acknowledge that AAAASF sets the “Gold Standard in Accreditation” (American Association for Accreditation of Ambulatory Surgery Facilities, n.d.).
35)  1980 Department of Health and Human Services (DHHS) The Office of Education and the Department of Health, Education and Welfare (HEW) became the Department of Health and Human Services (DHHS) (U.S. Department of Health & Human Services, n.d.).
36)  1981 Omnibus Budget Reconciliation Act (OBRA) The OBRA was federal legislation that expanded the Medicare and Medicaid programs. Government became more involved in nursing homes, including restraint restrictions (Svahn, 1981).
37)  1982 BCBS Association The Blue Cross Association and the National Association of Blue Shield merge to create the BlueCross BlueShield Association (BCBSA) (Young & Kroth, 2018).
38)  1983 Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) TEFRA created Medicare risk programs, which allowed federally qualified HMOs and competitive medical plans that met specified Medicare requirements to provide Medicare-covered services under a risk contract. TEFRA today is known as Medicare Part C or Medicare Advantage. The Act also enacted a prospective payment system (PPS), which is a predetermined payment for inpatient services based on diagnoses codes. The PPS went into effect in 1983 and is called diagnosis-related groups (DRGs), which is the hospital inpatient reimbursement system. Peer-review organizations (PROs), now called quality improvement organizations, or QIOs, were also created (Young & Kroth, 2018).
39)  1983 Inpatient Perspective Payment System (IPPS) Medicare IPPS is how hospitals are paid for inpatient stays. Each admission is coded with ICD-10-CM diagnoses and ICD-10-PCS hospital procedure codes. Based on the reason for the admission and the severity of illness and procedures performed, the inpatient stay is assigned a Diagnostic Related Group (DRG). The hospital is paid a flat fee for the cost-based DRG. Reimbursement is based on the primary diagnoses, comorbidities and complications (severity of Illness) and procedures performed (Young & Kroth, 2018; Centers for Medicare & Medicaid Services, 2021a).
40)  1984 CMS Standardization of Information submitted on Medicare Claims HCFA, now known as CMS, required providers to use the HCFA-1500 (now called the CMS-41500) to submit Medicare claims. The HCFA Common Procedure Coding System (HCPCS) (now called Health Care Procedure Coding System) was created, which included CPT, level II (national), and level III (local) codes. Commercial payers also adopted HCPCS coding and use of the CMS-1500 claim form. The CPT codes change yearly because technology and medical advancements drive the changes (Young & Kroth, 2018).
41)  1986 Consolidated Omnibus Budget Reconciliation Act (COBRA) Provides workers and their families who lose their health benefits the right to continue those benefits for 18 months or 36 months due to the death of a spouse (Young & Kroth, 2018).
42)  1988 Clinical Laboratory Improvement Act (CLIA) Clinical Laboratory Improvement Act (CLIA) legislation established quality standards for all laboratory testing to ensure the accuracy, reliability, and timeliness of patient test results regardless of where the test was performed (Centers for Medicare & Medicaid Services, 2021b).
43)  1989 Agency for Healthcare Research and Quality’s (AHRQ) The AHRQ mission is to produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable (Young & Kroth, 2018).
44)  1989 Health Plan Employer Data and Information Set (HEDIS) The National Committee for Quality Assurance (NCQA) developed the HEDIS, which created standards to assess managed care systems using data elements that are collected, evaluated, and published to compare the performance of managed health care plans (Young & Kroth, 2018).
45)  1991 Standardized Evaluation and Management Codes (Physician Office Visit CPT Codes) The AMA and CMS implement major revision of CPT, creating a new section called Evaluation and Management (E/M), which describes patient encounters where the physician must document for quality purpose; past, family and social history (PFSH), physical exam (PE), and medical decision making (MDM) (AMA, 1991).
46)  1991 National Committee for Quality Assurance (NCQA) The NCQA ensures the quality of managed care plans by providing standard and objective information about HMOs (Marjoua & Bozic, 2012).
47)  1992 Resource-Based Relative Value Scale (RBRVS) system Cost-based fee schedule for physicians under Omnibus Reconciliation Acts (OBRA) was created. Each CPT code is assigned a relative value unit (RVU) and multiplied with an annual conversion factor to reimburse the physician more cost-effectively based on their work, overhead, and risk of malpractice (McCormack & Burge, 1994).
48)  1993 Clinton proposed the Health Security Act of 1993 Based on six guiding principles of security, simplicity, savings, choice, quality, and personal responsibility (Young & Kroth, 2018).
49)  1996 National Correct Coding Initiative (NCCI) The NCCI was created to promote correct coding initiatives and to eliminate improper medical coding. NCCI edits are developed based on coding conventions defined in the American Medical Association’s Current Procedural Terminology (CPT) manual (Centers for Medicare & Medicaid Services, 2021f).
50)  1996 Health Insurance Portability and Accountability Act of 1996 (HIPAA) The HIPAA established regulations that govern privacy, security, and electronic transactions standards for health care information. It also created portability of health insurance when an employee terms from their job. The primary intent of HIPAA is to provide better access to health insurance, limit fraud and abuse, and reduce administrative costs (Young & Kroth, 2018).
51)  1997 Balanced Budget Act (BBA); Children’s Health Insurance Plan (CHIP); OIG Fraud & Abuse Audits Title XXI, State Children’s Health Insurance Program (SCHIP) established to provide uninsured, low-income children health insurance under state Medicaid programs. The Balanced Budget Act of 1997 (BBA) addresses health care fraud and abuse issues. The DHHS Office of the Inspector General (OIG) provides investigative and audit services in health care fraud cases (Young & Kroth, 2018).
52)  1999 Center for Improvement in Healthcare Quality (CIHQ) The CIHQ is a membership-based organization comprised primarily of acute care and critical access hospitals, for which it provides accreditation services (Center for Improvement in Healthcare Quality, n.d.).
53)  1999 Omnibus Consolidated and Emergency Supplemental Appropriations Act (OCE- SAA) amended the BBA of 1997 to require the development and implementation of a Home Health Prospective Payment System (HHPPS) The OCE-SAA required the development and implementation of a Home Health Prospective Payment System (HHPPS), which reimburses home health agencies at a predetermined rate for health care services provided to patients. The HHPPS was implemented October 1, 2000, and uses the Outcomes and Assessment Information Set (OASIS), a group of data elements that represent core items of a comprehensive assessment for an adult home care patient and form the basis for measuring patient outcomes for purposes of outcome-based quality improvement (McCall et al., 2013).
54)  2000 Outpatient Prospective Payment System (OPPS) Medicare’s OPPS is used to pay hospital outpatient services. Ambulatory Payment Classifications (APCs) are used to calculate reimbursement and is for hospital-based outpatient claims. It is a cost-based system that uses CPT codes and payment classifications to pay for similar services under group flat fee payments (Centers for Medicare & Medicaid Services, 2021e).
55)  2000 Benefits Improvement and Protection Act of 2000 (BIPA) The Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) requires implementation of a $400 billion prescription drug benefit, improved Medicare Advantage (formerly called Medicare+Choice) benefits, faster Medicare appeals decisions, and more (Young & Kroth, 2018).
56)  2000 Managed Market Competition; Consumer-driven health plans Markets were consolidating and managed care was accelerating, and consumer were driving the insurance market-driven health plans. Consumers want the best health care at the lowest cost. Consumer-driving plans were, for example, employer-paid with high-deductible insurance plans with medical savings accounts used by employees to cover deductibles and other medical costs when covered amounts are exceeded (Well, 2002).
57)  2001 Administrative Simplification Compliance Act (ASCA) The ASCA establishes the compliance date (October 16, 2003) for modifications to the Electronic Transaction Standards and Code Sets as required by HIPAA. Covered entities must submit Medicare claims electronically unless the Secretary of DHHS grants a waiver (Centers for Medicare & Medicaid Services, 2021c).
58)  2002 announced that quality improvement organizations (QIOs) CMS OIOs perform utilization and quality control review of health care furnished, or to be furnished, to Medicare beneficiaries. QIOs replaced peer review organizations (PROs), which previously performed this function (Young & Kroth, 2018).
59)  2005 National Provider Identifier, NPI The Standard Unique Health Identifier for Health Care Providers (or National Provider Identifier, NPI) is implemented (Centers for Medicare & Medicaid Services, 2021c).
60)  2005 Patient Safety and Quality Improvement Act of 2005 Amends Title IX of the Public Health Service Act to provide for improved patient safety and reduced incidence of events adversely affecting patient safety. It encourages the reporting of health care mistakes to patient safety organizations by making the reports confidential and shielding them from use in civil and criminal proceedings (Centers for Medicare & Medicaid Services, 2021c).
61)  2005 Deficit Reduction Act of 2005 Created the Medicaid Integrity Program (MIP), which is a fraud and abuse detection initiative and program (Young & Kroth, 2018).
62)  2006 Physician Quality Reporting Initiative (PQRI) or System (PQRS) The Tax Relief and Health Care Act of 2006 (TRHCA) authorized implementation of a physician quality reporting system that establishes a financial incentive for eligible professionals who participate in a voluntary quality reporting program (Young & Kroth, 2018).
63)  2009 American Recovery and Reinvestment Act of 2009 The American Recovery and Reinvestment Act (ARRA) authorized an expenditure of $1.5 billion for grants for construction, renovation and equipment, and the acquisition of health information technology systems (Young & Kroth, 2018).
64)  2009 Health Information Technology for Economic and Clinical Health (HITECH) Act The Health Information Technology for Economic and Clinical Health (HITECH) Act provides DHHS with the authority to establish programs to improve health care quality, safety, and efficiency through the promotion of health IT, including electronic health records and private and secure electronic health information exchange (Young & Kroth, 2018).
65)  2010 Patient Protection and Affordable Care Act (2010) The PPACA (2010) provides quality affordable access to health insurance for Americans. The Act provides a broader range of mandated prevention services, where patients are not to be charged copayments or deductibles on those services to incent them to get the preventive services. The Act eliminates lifetime caps on benefits and extends coverage of college students to age 26 (Young & Kroth, 2018).
66)  2014 National Coordinator for Health Information Technology (ONC) The ONC is the office that supports the administration’s healthIT.gov efforts. It is a primary resource to the entire health system to support the adoption of health information technology and the promotion of nationwide, standards-based health information exchange (HealthIT.gov, 2021).
67)  2015 Hospital Quality Reporting (HQR) and Initiative (H.Q.I.) The HQR began in 2003, mandated by the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003. Failure to successfully report resulted in a 0.4 percentage point reduction in the annual market basket used in the reimbursement. This increased to a 2.0 percent reduction under the Deficit Reduction Act of 2005. Under the American Recovery and Reinvestment Act of 2009 and the Affordable Care Act of 2010 the reduction is one-quarter of the hospital’s applicable annual payment rate in 2015 and beyond if all Hospital Inpatient Quality Reporting Program requirements are not met (Centers for Medicare & Medicaid Services, 2021d).
68)  2015 Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and Merit-based Incentive Payment System (MIPS) Repeals the Sustainable Growth Rate (PDF) formula, value-based purchasing. Implements MIPS, which combines the former PQRS reporting system with ePrescribe and meaningful use into the one program with four (4) components (Quality Payment Program, n.d.).
69)  2021 American Rescue Plan Act (ARPA) The American Rescue Plan Act of 2021, also called the COVID-19 Stimulus Package or American Rescue Plan. The ARPA expands A.C.A. health insurance subsidies and lowers costs (Centers for Medicare & Medicaid Services, 2021c).
70)  2021 Medicare Care Compare Medicare search engines that allow Medicare recipients to sign up, log in, and find and compare nursing homes, hospitals, physicians, other providers of care. There is also a look up externally for non-Medicare patients, but the data is limited. The compare data compares from the quality measures and cost data submitted through the quality reporting programs. The data provides transparency and was initiated by the consumerism movement in health care (Medicare.gov, 2021).
71)  2030-2000 Healthy People 2000, 2010,  2020, 2030 Healthy People 2030 is the fifth decade of the program. Healthy People 1990 began a ten-year population health initiative. Every ten years since its inception goals have been set, population health data is measured and outcomes are analyzed. The 1990 to 2000 span of time was the baseline of the program. For Healthy People 2000, the second iteration of the initiative, was guided by 3 broad goals: a) increase the span of healthy life, b) reduce health disparities and c) achieve access to preventive services for all. For Healthy People 2010, the focus increased on improving quality of life. The one significant overarching goal was to eliminate health disparities and not just simply reduce them. For Healthy People 2020 there were four goals: a) attain a high-quality of life; b) live longer without preventable disease, disability, injury, or premature death; c) achieve health equity and eliminate disparities; and d) improve all groups in regard to health status. Finally, for Healthy People 2030, the fifth iteration rolled out in August 2021, there is increased emphasis on the lessons learned over the last 4 decades to improve health equity, health literacy, and a new concentration on well-being (Health.gov, n.d.; Kroth, & Young, 2018).

 

 

 

References

 

Achermann, J. (2009). Small gifts and big trouble: Clarifying the Taft Hartley act. University of San Francisco Law Review, 44(1), 63–94.

American Association for Accreditation of Ambulatory Surgery Facilities. (n.d.). We maintain the highest standards for outpatient accreditation. https://www.aaaasf.org/who-we-are/

Center for Improvement in Healthcare Quality. (n.d.). Welcome to CIHQ. https://www.cihq.org/

Centers for Medicare & Medicaid Services. (2021a). Acute inpatient PPS. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS

Centers for Medicare & Medicaid Services. (2021b). Clinical laboratory improvement amendments (CLIA). https://www.cms.gov/Regulations-and-Guidance/Legislation/CLIA

Centers for Medicare & Medicaid Services. (2021c). CY 2002 Physician fee schedule proposed rule with comment period. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched

Centers for Medicare & Medicaid Services. (2021d). Hospital inpatient quality reporting program. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/HospitalRHQDAPU

Centers for Medicare & Medicaid Services. (2021e). Hospital outpatient prospective payment system (OPPS). https://www.cms.gov/Research-Statistics-Data-and-Systems/Files-for-Order/LimitedDataSets/HospitalOPPS

Centers for Medicare & Medicaid Services. (2021f). National correct coding initiative edits. https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd

Chaudhry, H.J. (2010). The important role of medical licensure in the United States. Academic Medicine, 85(11), 1657. doi:10.1097/ACM.0b013e3181f557ed

Derickson A. (2002). “Health for three-thirds of the nation:” Public health advocacy of universal access to medical care in the United States. American Journal of Public Health, 92(2), 180–190. https://doi.org/10.2105/ajph.92.2.180

Dotson P. (2013). CPT® Codes: What are they, why are they necessary, and how are they developed?. Advances in Wound Care, 2(10), 583–587. https://doi.org/10.1089/wound.2013.0483

Gabay M. (2013). The federal controlled substances act: Schedules and pharmacy registration. Hospital pharmacy, 48(6), 473–474. https://doi.org/10.1310/hpj4806-473

Health.gov. (n.d.). History of healthy people. https://health.gov/our-work/healthy-people/about-healthy-people/history-healthy-people

HealthIT.gov. (2021). https://www.healthit.gov/

Marjoua, Y., & Bozic, K. J. (2012). Brief history of quality movement in US healthcare. Current reviews in Musculoskeletal Medicine, 5(4), 265–273. https://doi.org/10.1007/s12178-012-9137-8

McCall, N., Korb, J., Petersons, A., & Moore, S. (2003). Reforming Medicare payment: Early effects of the 1997 Balanced Budget Act on postacute care. The Milbank Quarterly, 81(2), 277–173. https://doi.org/10.1111/1468-0009.t01-1-00054

McCormack, L. A., & Burge, R. T. (1994). Diffusion of Medicare’s RBRVS and related physician payment policies. Health Care Financing Review, 16(2), 159-173. https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/HealthCareFinancingReview/Downloads/CMS1191353dl.pdf

Medicare.gov. (2021). Find & compare nursing homes, hospitals & other providers near you.  https://www.medicare.gov/care-compare/

Moehling, C. M., & Thomasson, M. A. (2012, April). Saving babies: The contribution of Sheppard-Towner to the decline in infant mortality in the 1920s (Working Paper 17996.). National Bureau of Economic Research. https://www.nber.org/system/files/working_papers/w17996/w17996.pdf

Quality Payment Program. (n.d.). APMs overview. https://qpp.cms.gov/apms/overview

Reilly R. F. (2016). Medical and surgical care during the American Civil War, 1861-1865. Baylor University Medical Center Proceedings, 29(2), 138–142. https://doi.org/10.1080/08998280.2016.11929390

Scofea,L. A. (1994). The development and growth of employer-provider health insurance. Monthly Labor Review, 117(3), 3–10. https://www.bls.gov/opub/mlr/1994/03/art1full.pdf

Svahn, J. A. (1981). Omnibus Reconciliation Act of 1981: Legislative history and summary of OASDI and Medicare provisions. Social Security Bulletin., 44(10). https://www.ssa.gov/policy/docs/ssb/v44n10/v44n10p3.pdf

Truex E. S. (2014). Medical licensing and discipline in America: A history of the Federation of State Medical Boards. Journal of the Medical Library Association, 102(2), 133–134. https://doi.org/10.3163/1536-5050.102.2.019

University of Pennsylvania School of Nursing. (n.d.). History of hospitals. https://www.nursing.upenn.edu/nhhc/nurses-institutions-caring/history-of-hospitals/

United States Nuclear Regulatory Commission. (2020). Medical uses of nuclear materials. https://www.nrc.gov/materials/miau/med-use.html

U.S. Department of Health &  Human Services. (n.d.). HHS historical highlights. https://www.hhs.gov/about/historical-highlights/index.html

U.S. Department of Labor. (n.d.). Procedure manual; Division of federal employees’ compensation (DFEC). https://www.dol.gov/agencies/owcp/FECA/regs/compliance/DFECfolio/FECA-PT0

U.S. Food and Drug Administration. (n.d.). Part II: 1938, Food, Drug, Cosmetic Act.  https://www.fda.gov/about-fda/changes-science-law-and-regulatory-authorities/part-ii-1938-food-drug-cosmetic-act

United States National Health Program: Wagner, bill, S. 1620. (1939). California and Western Medicine, 51(3), 214–215.

Warne, D., & Frizzell, L. B. (2014). American Indian health policy: Historical trends and contemporary issues. American Journal of Public Health, 104(Suppl 3), S263–S267. https://doi.org/10.2105/AJPH.2013.301682

Weedn, V. W. (2020). Origins of the armed forces medical examiner system. Academic Forensic Pathology, 10(1),16–34. doi:10.1177/1925362120937916

Weil, T. P. (2002, Summer). Managed competition using both market-driven and regulatory strategies. Managed Care Quarterly, 10(3), 32–40.

Young, K. M., & Kroth, P. J. (2018). Sultz & Young’s health care USA: Understanding Its organization and delivery (9th ed.). Jones & Bartlett.

 

The Healthcare Quality Evolution

 

 

Health Care Quality Evolution Milestone Events Chart

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Health Care Quality Evolution Milestone Events Chart

Health Care Quality Evolution Milestone Events Chart

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Healthcare Legislation, Regulatory Agencies, and Quality Initiatives Milestone Description
1)     1791 Regulating Healthcare Health Care Quality Evolution Milestone Events Chart States were given the right to regulate health and formally began licensing physicians (Chaudhry, 2010).
2)     1800 State medical boards State medical boards license, discipline, and regulate physicians and other health care professionals to protect the public (Truex, 2014).
3)     1850 First health insurance policy The Franklin Health Assurance Company of Massachusetts was the first commercial insurance company in the U.S. to provide private health care coverage benefits for injuries not resulting in death (Scofea, 1994).
4)     1862 U.S. Army Medical Department and the United States Sanitary Commission formed Post-Civil War, new health-related agencies, hospitals, and medical research and care implemented to care for the post-Civil War injured and increase population health awareness (Reilly, 2016).
5)     1886 U.S. Army established the Hospital Corps The first U.S. data repository to collect medical data. This was implemented by the Surgeon General’s Office and the Library of the Surgeon General (Weedn, 2020).
6)     1900 Self-pay is the primary source of payment for healthcare services Most Americans continued to pay their own health care expenses, which often meant either uncompensated charity care or no care. Hospitals were voluntary institutions that were privately supported (University of Pennsylvania School of Nursing, n.d.).
7)     1908 Workers’ compensation legislation President Theodore Roosevelt signed legislation to provide workers’ compensation (WC) for certain federal employees in unusually hazardous jobs (U.S. Department of Labor, n.d.).
8)     1915 American Association of Labor Legislation (AALL) The first universal access health insurance legislation. It would provide limited insurance benefits to working class, their dependents, and others who earned less than $1,200 a year. Although supported by the American Medical Association (AMA), it was never passed into law (Derickson, 2002).
9)     1916 The Federal Employees’ Compensation Act (FECA) Replaced the 1908 WC legislation to include civilian employees of the federal government. They were provided medical care, survivors’ benefits, and compensation for lost wages under FECA (U.S. Department of Labor, n.d.).
10)  1920 Introduction of prepaid health plans (direct contracting) Direct contracting between employers, local hospitals, and physicians for medical services was the first predetermined fee that was paid monthly or yearly basis. These prepaid health plans were the precursor of today’s managed care plans and capitation payments (Young & Kroth, 2018).
11)  1921 -1976 Indian Health Services (IHS) The Snyder Act of 1921 and the Indian Health Care Improvement Act (IHCIA) of 1976 created the legislative authority for Congress to provide funding to Native Americans for health care services, which is now known as the Indian Health Services (IHS) (Warne & Frizzell, 2014).
12)  1921 Sheppard-Towner Maternity and Infancy Act Legislation to reduce maternal and infant mortality. The Act was challenged and then said to be unconstitutional by the Supreme Court. Additionally, the Act was opposed by the American Medical Association. The act was not renewed and expired in 1929. (Moehling & Thomasson, 2012).
13)  1927 Workers’ Compensation Act Office of Workers’ Compensation Programs (OWCP) administers FECA as well as the Longshore and Harbor Workers’ Compensation Act of 1927 and the Black Lung Benefits Reform Act of 1977 (Young & Kroth, 2018).
14)  1929 Blue Cross (BC) Insurance Policy Baylor University, Dallas, TX, guaranteed schoolteachers 21 days of hospital care for $6 a year. Other groups of employees in Dallas joined, and in a short time period BC becomes hospital insurance nationwide (Young & Kroth, 2018).
15)  1930 Blue Shield (BS) Plans Blue Shield (BS) was founded to provide insurance to lumber and mining camps of the Pacific Northwest at the turn of the century. Employers paid fees to medical service bureaus, which were composed of groups of physicians. BS becomes physician insurance nationwide (Young & Kroth, 2018).
16)  1938 The Food, Drug, and Cosmetic Act was signed by President Franklin Delano Roosevelt Food, drug, and cosmetic safety implemented. The new law brought cosmetics and medical devices under control, and it required that drugs should be labeled with adequate directions for safe use (Young & Kroth, 2018; FDA, n.d.).
17)  1939 Wagner National Health Act (S.1620) The bill would have allowed the states to implement mandatory and universal health care but did not pass due to WWII (United States national health program: Wagner, bill, S. 1620, 1939).
18)  1946 Hill-Burton Act Provided federal grants for modernizing hospitals during the Great Depression and WWII (1929-1945). In return for federal funds, hospitals were required to provide services free or at reduced rates to patients unable to pay for care (Young & Kroth, 2018).
19)  1947 Taft-Hartley Act Amended the National Labor Relations Act of 1932, restoring a more balanced relationship between labor and management. An indirect result of Taft-Hartley was the creation of third-party administrators (TPAs), which administer health care plans and process claims, thus serving as a system of checks and balances for labor and management (Achermann, 2009).
20)  1948 International Classification of Disease (ICD), World Health Organization (WHO). Classification system used to collect diagnoses for statistical purposes. Originally used for mortality reporting but later and today used for morbidity reporting as well (Young & Kroth, 2018).
21)  1950 Major medical insurance Birth of the major medical insurance for catastrophic and prolonged illness, with deductibles and lifetime maximum benefit amounts (Young & Kroth, 2018).
22)  1951 The Joint Commission (JC): Facility Accreditation The Joint Commission does accreditation for hospitals and other medical facilities to ensure the facilities pass CMS, state and other inspections and ensure that services and facilities are safe and effective care of the highest quality and value (Young & Kroth, 2018).
23)  1956 Dependents’ Medical Care Act The Dependents’ Medical Care Act of 1956 was signed into law and provided health care to dependents of active military personnel (precursor to CHAMPVA 1973 and now TriCare 1988) (Young & Kroth, 2018).
24)  1966 Social Security Amendments of 1965 Medicare-Title XVIII insurance for Americans over the age of sixty-five (65). Medicaid-Title XIX a cost-sharing program between the federal and state governments to provide health care services to low-income Americans (Young & Kroth, 2018).
25)  1966 Current Procedural Terminology (CPT) The Current Procedural Terminology (CPT) codes were developed by the AMA in 1966 as a way to describe and track physician and other professional medical services. The CPT Code book is updated annually, and changes go into effect on January 1 of each new year (Dotson, 2013).
26)  1970 Controlled Substances Act (CSA); Drug Enforcement Agency (DEA): Controlled substances Controlled Substances Act (CSA) was created to improve the manufacturing, importation and exportation, distribution, and dispensing of controlled substances. Manufacturers, distributors, and dispensers of controlled substances must be registered with the Drug Enforcement Administration (DEA) (Gabay, 2013).
27)  1970 Occupational Safety and Health Administration Act OSHA) The Occupational Safety and Health Administration Act (OSHA) was designed to protect all employees against injuries from occupational hazards in the workplace (Young & Kroth, 2018).
28)  1972 Professional Standards Review Organizations (PSROs) Created as part of Title XI of the Social Security Amendments Act of 1972 were Professional Standards Review Organizations (PSROs), which were physician-controlled nonprofit organizations that contracted with CMS to provide for the review of hospital inpatient resource utilization, quality of care, and medical necessity. The PSROs were replaced with Peer Review Organizations (PROs), as a result of the Tax Equity and Fiscal Responsibility Act of 1982, or TEFRA (Young & Kroth, 2018).
29)  1973 Health Maintenance Organization Act The Health Maintenance Organization Assistance Act of 1973 authorized federal grants and loans to private organizations that wished to develop health maintenance organizations (HMOs), which are responsible for providing health care services to subscribers in a given geographic area for a fixed fee (Young & Kroth, 2018).
30)  1974 Employee Retirement Income Security Act of 1974 (ERISA) ERISA is a federal law that sets minimum standards for most voluntarily established retirement and health plans in private industry to provide protection for individuals in these plans. This law allows employers to be self-insured (Young & Kroth, 2018).
31)  1975 U.S. Nuclear Regulatory Commission (NRC) The NRC is a federal agency that ensures safe use of radioactive materials. They license and regulate the nation’s civilian use of radioactive materials to provide reasonable assurance of adequate safety for people and the environment. In health care this would include all diagnostic medical use, therapeutic medical use, and medical research use (United States Nuclear Regulatory Commission, 2020).
32)  1976 Food and Drug Administration (F.D.A.): Medical Equipment   FDA: Medical Device Amendments passed to ensure safety and effectiveness of medical devices, including diagnostic products (FDA, n.d.).
33)  1977 Health Care Financing Administration (HCFA) The DHHS combine health care financing and quality assurance programs into one agency, HCFA. Medicare and Medicaid programs were transferred to HCFA, which is now CMS (Young & Kroth, 2018).
34)  1980 American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF)             The AAAASF was established to standardize and improve the quality of health care in outpatient facilities. AAAASF accredits thousands of facilities worldwide including clinics, surgery centers, and state/federal health agencies, and patients acknowledge that AAAASF sets the “Gold Standard in Accreditation” (American Association for Accreditation of Ambulatory Surgery Facilities, n.d.).
35)  1980 Department of Health and Human Services (DHHS) The Office of Education and the Department of Health, Education and Welfare (HEW) became the Department of Health and Human Services (DHHS) (U.S. Department of Health & Human Services, n.d.).
36)  1981 Omnibus Budget Reconciliation Act (OBRA) The OBRA was federal legislation that expanded the Medicare and Medicaid programs. Government became more involved in nursing homes, including restraint restrictions (Svahn, 1981).
37)  1982 BCBS Association The Blue Cross Association and the National Association of Blue Shield merge to create the BlueCross BlueShield Association (BCBSA) (Young & Kroth, 2018).
38)  1983 Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) TEFRA created Medicare risk programs, which allowed federally qualified HMOs and competitive medical plans that met specified Medicare requirements to provide Medicare-covered services under a risk contract. TEFRA today is known as Medicare Part C or Medicare Advantage. The Act also enacted a prospective payment system (PPS), which is a predetermined payment for inpatient services based on diagnoses codes. The PPS went into effect in 1983 and is called diagnosis-related groups (DRGs), which is the hospital inpatient reimbursement system. Peer-review organizations (PROs), now called quality improvement organizations, or QIOs, were also created (Young & Kroth, 2018).
39)  1983 Inpatient Perspective Payment System (IPPS) Medicare IPPS is how hospitals are paid for inpatient stays. Each admission is coded with ICD-10-CM diagnoses and ICD-10-PCS hospital procedure codes. Based on the reason for the admission and the severity of illness and procedures performed, the inpatient stay is assigned a Diagnostic Related Group (DRG). The hospital is paid a flat fee for the cost-based DRG. Reimbursement is based on the primary diagnoses, comorbidities and complications (severity of Illness) and procedures performed (Young & Kroth, 2018; Centers for Medicare & Medicaid Services, 2021a).
40)  1984 CMS Standardization of Information submitted on Medicare Claims HCFA, now known as CMS, required providers to use the HCFA-1500 (now called the CMS-41500) to submit Medicare claims. The HCFA Common Procedure Coding System (HCPCS) (now called Health Care Procedure Coding System) was created, which included CPT, level II (national), and level III (local) codes. Commercial payers also adopted HCPCS coding and use of the CMS-1500 claim form. The CPT codes change yearly because technology and medical advancements drive the changes (Young & Kroth, 2018).
41)  1986 Consolidated Omnibus Budget Reconciliation Act (COBRA) Provides workers and their families who lose their health benefits the right to continue those benefits for 18 months or 36 months due to the death of a spouse (Young & Kroth, 2018).
42)  1988 Clinical Laboratory Improvement Act (CLIA) Clinical Laboratory Improvement Act (CLIA) legislation established quality standards for all laboratory testing to ensure the accuracy, reliability, and timeliness of patient test results regardless of where the test was performed (Centers for Medicare & Medicaid Services, 2021b).
43)  1989 Agency for Healthcare Research and Quality’s (AHRQ) The AHRQ mission is to produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable (Young & Kroth, 2018).
44)  1989 Health Plan Employer Data and Information Set (HEDIS) The National Committee for Quality Assurance (NCQA) developed the HEDIS, which created standards to assess managed care systems using data elements that are collected, evaluated, and published to compare the performance of managed health care plans (Young & Kroth, 2018).
45)  1991 Standardized Evaluation and Management Codes (Physician Office Visit CPT Codes) The AMA and CMS implement major revision of CPT, creating a new section called Evaluation and Management (E/M), which describes patient encounters where the physician must document for quality purpose; past, family and social history (PFSH), physical exam (PE), and medical decision making (MDM) (AMA, 1991).
46)  1991 National Committee for Quality Assurance (NCQA) The NCQA ensures the quality of managed care plans by providing standard and objective information about HMOs (Marjoua & Bozic, 2012).
47)  1992 Resource-Based Relative Value Scale (RBRVS) system Cost-based fee schedule for physicians under Omnibus Reconciliation Acts (OBRA) was created. Each CPT code is assigned a relative value unit (RVU) and multiplied with an annual conversion factor to reimburse the physician more cost-effectively based on their work, overhead, and risk of malpractice (McCormack & Burge, 1994).
48)  1993 Clinton proposed the Health Security Act of 1993 Based on six guiding principles of security, simplicity, savings, choice, quality, and personal responsibility (Young & Kroth, 2018).
49)  1996 National Correct Coding Initiative (NCCI) The NCCI was created to promote correct coding initiatives and to eliminate improper medical coding. NCCI edits are developed based on coding conventions defined in the American Medical Association’s Current Procedural Terminology (CPT) manual (Centers for Medicare & Medicaid Services, 2021f).
50)  1996 Health Insurance Portability and Accountability Act of 1996 (HIPAA) The HIPAA established regulations that govern privacy, security, and electronic transactions standards for health care information. It also created portability of health insurance when an employee terms from their job. The primary intent of HIPAA is to provide better access to health insurance, limit fraud and abuse, and reduce administrative costs (Young & Kroth, 2018).
51)  1997 Balanced Budget Act (BBA); Children’s Health Insurance Plan (CHIP); OIG Fraud & Abuse Audits Title XXI, State Children’s Health Insurance Program (SCHIP) established to provide uninsured, low-income children health insurance under state Medicaid programs. The Balanced Budget Act of 1997 (BBA) addresses health care fraud and abuse issues. The DHHS Office of the Inspector General (OIG) provides investigative and audit services in health care fraud cases (Young & Kroth, 2018).
52)  1999 Center for Improvement in Healthcare Quality (CIHQ) The CIHQ is a membership-based organization comprised primarily of acute care and critical access hospitals, for which it provides accreditation services (Center for Improvement in Healthcare Quality, n.d.).
53)  1999 Omnibus Consolidated and Emergency Supplemental Appropriations Act (OCE- SAA) amended the BBA of 1997 to require the development and implementation of a Home Health Prospective Payment System (HHPPS) The OCE-SAA required the development and implementation of a Home Health Prospective Payment System (HHPPS), which reimburses home health agencies at a predetermined rate for health care services provided to patients. The HHPPS was implemented October 1, 2000, and uses the Outcomes and Assessment Information Set (OASIS), a group of data elements that represent core items of a comprehensive assessment for an adult home care patient and form the basis for measuring patient outcomes for purposes of outcome-based quality improvement (McCall et al., 2013).
54)  2000 Outpatient Prospective Payment System (OPPS) Medicare’s OPPS is used to pay hospital outpatient services. Ambulatory Payment Classifications (APCs) are used to calculate reimbursement and is for hospital-based outpatient claims. It is a cost-based system that uses CPT codes and payment classifications to pay for similar services under group flat fee payments (Centers for Medicare & Medicaid Services, 2021e).
55)  2000 Benefits Improvement and Protection Act of 2000 (BIPA) The Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) requires implementation of a $400 billion prescription drug benefit, improved Medicare Advantage (formerly called Medicare+Choice) benefits, faster Medicare appeals decisions, and more (Young & Kroth, 2018).
56)  2000 Managed Market Competition; Consumer-driven health plans Markets were consolidating and managed care was accelerating, and consumer were driving the insurance market-driven health plans. Consumers want the best health care at the lowest cost. Consumer-driving plans were, for example, employer-paid with high-deductible insurance plans with medical savings accounts used by employees to cover deductibles and other medical costs when covered amounts are exceeded (Well, 2002).
57)  2001 Administrative Simplification Compliance Act (ASCA) The ASCA establishes the compliance date (October 16, 2003) for modifications to the Electronic Transaction Standards and Code Sets as required by HIPAA. Covered entities must submit Medicare claims electronically unless the Secretary of DHHS grants a waiver (Centers for Medicare & Medicaid Services, 2021c).
58)  2002 announced that quality improvement organizations (QIOs) CMS OIOs perform utilization and quality control review of health care furnished, or to be furnished, to Medicare beneficiaries. QIOs replaced peer review organizations (PROs), which previously performed this function (Young & Kroth, 2018).
59)  2005 National Provider Identifier, NPI The Standard Unique Health Identifier for Health Care Providers (or National Provider Identifier, NPI) is implemented (Centers for Medicare & Medicaid Services, 2021c).
60)  2005 Patient Safety and Quality Improvement Act of 2005 Amends Title IX of the Public Health Service Act to provide for improved patient safety and reduced incidence of events adversely affecting patient safety. It encourages the reporting of health care mistakes to patient safety organizations by making the reports confidential and shielding them from use in civil and criminal proceedings (Centers for Medicare & Medicaid Services, 2021c).
61)  2005 Deficit Reduction Act of 2005 Created the Medicaid Integrity Program (MIP), which is a fraud and abuse detection initiative and program (Young & Kroth, 2018).
62)  2006 Physician Quality Reporting Initiative (PQRI) or System (PQRS) The Tax Relief and Health Care Act of 2006 (TRHCA) authorized implementation of a physician quality reporting system that establishes a financial incentive for eligible professionals who participate in a voluntary quality reporting program (Young & Kroth, 2018).
63)  2009 American Recovery and Reinvestment Act of 2009 The American Recovery and Reinvestment Act (ARRA) authorized an expenditure of $1.5 billion for grants for construction, renovation and equipment, and the acquisition of health information technology systems (Young & Kroth, 2018).
64)  2009 Health Information Technology for Economic and Clinical Health (HITECH) Act The Health Information Technology for Economic and Clinical Health (HITECH) Act provides DHHS with the authority to establish programs to improve health care quality, safety, and efficiency through the promotion of health IT, including electronic health records and private and secure electronic health information exchange (Young & Kroth, 2018).
65)  2010 Patient Protection and Affordable Care Act (2010) The PPACA (2010) provides quality affordable access to health insurance for Americans. The Act provides a broader range of mandated prevention services, where patients are not to be charged copayments or deductibles on those services to incent them to get the preventive services. The Act eliminates lifetime caps on benefits and extends coverage of college students to age 26 (Young & Kroth, 2018).
66)  2014 National Coordinator for Health Information Technology (ONC) The ONC is the office that supports the administration’s healthIT.gov efforts. It is a primary resource to the entire health system to support the adoption of health information technology and the promotion of nationwide, standards-based health information exchange (HealthIT.gov, 2021).
67)  2015 Hospital Quality Reporting (HQR) and Initiative (H.Q.I.) The HQR began in 2003, mandated by the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003. Failure to successfully report resulted in a 0.4 percentage point reduction in the annual market basket used in the reimbursement. This increased to a 2.0 percent reduction under the Deficit Reduction Act of 2005. Under the American Recovery and Reinvestment Act of 2009 and the Affordable Care Act of 2010 the reduction is one-quarter of the hospital’s applicable annual payment rate in 2015 and beyond if all Hospital Inpatient Quality Reporting Program requirements are not met (Centers for Medicare & Medicaid Services, 2021d).
68)  2015 Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and Merit-based Incentive Payment System (MIPS) Repeals the Sustainable Growth Rate (PDF) formula, value-based purchasing. Implements MIPS, which combines the former PQRS reporting system with ePrescribe and meaningful use into the one program with four (4) components (Quality Payment Program, n.d.).
69)  2021 American Rescue Plan Act (ARPA) The American Rescue Plan Act of 2021, also called the COVID-19 Stimulus Package or American Rescue Plan. The ARPA expands A.C.A. health insurance subsidies and lowers costs (Centers for Medicare & Medicaid Services, 2021c).
70)  2021 Medicare Care Compare Medicare search engines that allow Medicare recipients to sign up, log in, and find and compare nursing homes, hospitals, physicians, other providers of care. There is also a look up externally for non-Medicare patients, but the data is limited. The compare data compares from the quality measures and cost data submitted through the quality reporting programs. The data provides transparency and was initiated by the consumerism movement in health care (Medicare.gov, 2021).
71)  2030-2000 Healthy People 2000, 2010,  2020, 2030 Healthy People 2030 is the fifth decade of the program. Healthy People 1990 began a ten-year population health initiative. Every ten years since its inception goals have been set, population health data is measured and outcomes are analyzed. The 1990 to 2000 span of time was the baseline of the program. For Healthy People 2000, the second iteration of the initiative, was guided by 3 broad goals: a) increase the span of healthy life, b) reduce health disparities and c) achieve access to preventive services for all. For Healthy People 2010, the focus increased on improving quality of life. The one significant overarching goal was to eliminate health disparities and not just simply reduce them. For Healthy People 2020 there were four goals: a) attain a high-quality of life; b) live longer without preventable disease, disability, injury, or premature death; c) achieve health equity and eliminate disparities; and d) improve all groups in regard to health status. Finally, for Healthy People 2030, the fifth iteration rolled out in August 2021, there is increased emphasis on the lessons learned over the last 4 decades to improve health equity, health literacy, and a new concentration on well-being (Health.gov, n.d.; Kroth, & Young, 2018).

 

 

 

References

 

Achermann, J. (2009). Small gifts and big trouble: Clarifying the Taft Hartley act. University of San Francisco Law Review, 44(1), 63–94.

American Association for Accreditation of Ambulatory Surgery Facilities. (n.d.). We maintain the highest standards for outpatient accreditation. https://www.aaaasf.org/who-we-are/

Center for Improvement in Healthcare Quality. (n.d.). Welcome to CIHQ. https://www.cihq.org/

Centers for Medicare & Medicaid Services. (2021a). Acute inpatient PPS. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS

Centers for Medicare & Medicaid Services. (2021b). Clinical laboratory improvement amendments (CLIA). https://www.cms.gov/Regulations-and-Guidance/Legislation/CLIA

Centers for Medicare & Medicaid Services. (2021c). CY 2002 Physician fee schedule proposed rule with comment period. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched

Centers for Medicare & Medicaid Services. (2021d). Hospital inpatient quality reporting program. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/HospitalRHQDAPU

Centers for Medicare & Medicaid Services. (2021e). Hospital outpatient prospective payment system (OPPS). https://www.cms.gov/Research-Statistics-Data-and-Systems/Files-for-Order/LimitedDataSets/HospitalOPPS

Centers for Medicare & Medicaid Services. (2021f). National correct coding initiative edits. https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd

Chaudhry, H.J. (2010). The important role of medical licensure in the United States. Academic Medicine, 85(11), 1657. doi:10.1097/ACM.0b013e3181f557ed

Derickson A. (2002). “Health for three-thirds of the nation:” Public health advocacy of universal access to medical care in the United States. American Journal of Public Health, 92(2), 180–190. https://doi.org/10.2105/ajph.92.2.180

Dotson P. (2013). CPT® Codes: What are they, why are they necessary, and how are they developed?. Advances in Wound Care, 2(10), 583–587. https://doi.org/10.1089/wound.2013.0483

Gabay M. (2013). The federal controlled substances act: Schedules and pharmacy registration. Hospital pharmacy, 48(6), 473–474. https://doi.org/10.1310/hpj4806-473

Health.gov. (n.d.). History of healthy people. https://health.gov/our-work/healthy-people/about-healthy-people/history-healthy-people

HealthIT.gov. (2021). https://www.healthit.gov/

Marjoua, Y., & Bozic, K. J. (2012). Brief history of quality movement in US healthcare. Current reviews in Musculoskeletal Medicine, 5(4), 265–273. https://doi.org/10.1007/s12178-012-9137-8

McCall, N., Korb, J., Petersons, A., & Moore, S. (2003). Reforming Medicare payment: Early effects of the 1997 Balanced Budget Act on postacute care. The Milbank Quarterly, 81(2), 277–173. https://doi.org/10.1111/1468-0009.t01-1-00054

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The Healthcare Quality Evolution

 

 

Capstone Report FINAL

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Capstone Report FINAL

Capstone Report FINAL

ORDER A PLAGIARISM FREE PAPER NOW

Maximum length: 4000 words (excluding references and appendices)

Marks: 50%

Objective: To demonstrate key learning and skills developed throughout the course by creating a written report addressed to the executives of the company partner on a viable strategy, supported by utilization of appropriate frameworks and in-depth research, to effectively address the business challenge presented at the beginning of the quarter. Capstone Report FINAL

Directions:

  1. Develop a strategic plan for the case company to implement in the next 24 months that meets the challenge, in the form of a written report for the management team.Consistent with the final project rubrics, your report must include at least the following components:
    1. Executive summary;
    2. Internal analysis;
    3. External analysis;
    4. Problem definition;
    5. Strategy development(including alternatives to your final recommendation);
    6. Strategy evaluation and choice; and,
    7. Strategy implementation.
  2. You are encouraged to incorporate, in a holistic manner, the content and more importantly the feedback from Draft #1 and the Group Report.

Important: For Draft 1 and Final Report as well as Group Report:

  • Adopt a company-report style (vs. academic-report style). Incorporate figures and tables within the body of the document, along with the source of information in the graphic/table. Provide a list of references. You may add appendices for supporting materials not critical to the main report.
  • References and appendices are not included in the word limit. Footnotes are the preferred location for in-text references. Include a final list of references cited.
  • Utilizing the Business Communications Team’s draft points before the final submission is highly recommended.