Part III – Official goals and challenges of U.S. health care reform – A hope for better care, delivery, and costs

We have journeyed through the aspirations of the up-in-coming reform of the U.S. health care system with cost cutting tactics, preventative procedures, incentivizing medical industry and now, in part three, we will reviewU.S. Health Care Reform Update the last set of guidelines through measure and patients rights.

Helping individuals to take control over their own medical needs

  • Hospital-Acquired Conditions (HAC) – beneficiaries will be able to obtain information on the incidence of serious HACs as they occur at various hospitals. Hospitals will experience a decrease in payments if they have a high rate of HACs by the 2015 fiscal year.
  • Right to Quality Care in Writing – the majority of providers and suppliers are now obligated to inform beneficiaries of their right to communicate with the survey agency with their state and to register a complaint with one of the Quality Improvement Organizations (QIOs) for Medicare.
  • Quality Information Access – Medicare performance reports for physicians, hospitals and other healthcare providers will be made available to organizations that qualify, so that employers and consumers will have a larger amount of information to consider before making their decisions. It is hoped that this will help to encourage competition and keep costs at a minimum.

Healthcare quality measure development

  • Hospitals – new measures for the reporting of hospital quality have recently been proposed.
  • Hospices – starting in 2012, hospices will have to report on quality measures (including for the management of pain). The penalty for failing to submit this report by 2012 is a reduction of 2 percent in their inflation update.
  • Inpatient Rehab Facilities – starting in 2012, these facilities must report two out of the nine conditions from the Partnership for Patients program, and must measure a third under development in order to manage the occurrence of readmission inside 30 days.

Other reforms currently occurring within the system

  • Overall Improvement to Quality
  • ePrescribing and Quality Reporting for Physicians
  • Innovation Center for Medicare and Medicaid
  • New Authority Within the States to Link Payment to Medicaid Quality

Though the efforts and initiatives within the healthcare reforms have been extensive, the benefits are designed for the long-term and have yet to be witnessed. Only time will tell which of these elements will be success and where further reform will be required.

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