Competencies
7022.1.3 : Licensure, Certification, and Accreditation Standards
The graduate analyzes how licensing, certification, and accreditation agencies for healthcare organizations impact healthcare delivery at federal, state, local, and organizational levels.
7022.1.4 : Quality, Reimbursement, and Patient Access to Healthcare
The graduate analyzes how relationships between clinical healthcare quality, reimbursement for services, and patient access to medical care influence the services that are provided at various levels of healthcare organizations.
7022.1.5 : Federal Healthcare Legislation and Programs
The graduate analyzes how federal legislation and programs influence the provision of services at all levels of healthcare organizations.
Introduction
The healthcare ecosystem is influenced by external forces in the form of government regulations, accreditation standards, and federal legislation. These regulations and legislation are components of federal government programs and bring with them directives that may impact the economics of healthcare.
As greater numbers of healthcare organizations implement information systems across the United States, a seamless exchange of health information may provide consumers with a higher quality of care, improvement in patient access, and more efficient control of the cost of healthcare services. The healthcare ecosystem is one of continuous change, and health information management is supporting many of the changes.
Requirements
Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. An originality report is provided when you submit your task that can be used as a guide.
You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.
A. Analyze one federal government payer program for healthcare services (i.e., Medicare, Federal Employees Health Benefits Program, Indian Health Service, or TRICARE) making an impact on today’s healthcare ecosystem by doing the following:
1. Explain how your chosen federal government payer program impacts licensure, certification, or accreditation standards.
2. Explain how your chosen federal government payer program influences each of the following:
a. clinical quality reporting systems
b. reimbursement for healthcare services
c. patient access to care
B. Evaluate how health information management plays a part in your chosen federal government payer program by discussing a specific professional role within the HIM profession and how the role supports the goals of the chosen federal government payer program.
C. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.
File Restrictions
File name may contain only letters, numbers, spaces, and these symbols: ! - _ . * ' ( )
File size limit: 200 MB
File types allowed: doc, docx, rtf, xls, xlsx, ppt, pptx, odt, pdf, txt, qt, mov, mpg, avi, mp3, wav, mp4, wma, flv, asf, mpeg, wmv, m4v, svg, tif, tiff, jpeg, jpg, gif, png, zip, rar, tar, 7z
Rubric