HCS/430: Legal Issues In Health Care: Regulation And Compliance
Wk 1 Individual Assignment: Health Care Laws and Regulatory Issues [Due Day 7 – Monday]
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As a medical professor, it is important to educate and prepare our students on the regulations and compliance issues within the healthcare industry. One significant area of focus is on the legal issues that surround healthcare policy and how they become laws. In this response, we will provide an answer to the question posed regarding health care laws and regulatory issues in the context of the HCS/430: Legal Issues In Health Care: Regulation And Compliance course.
The chosen article for this assignment is “CMS initiative reducing hospital admissions fails to cut readmissions” written by Maria Castellucci and published on Modern Healthcare in 2019. The article discusses an initiative by the Centers for Medicare and Medicaid Services (CMS) that sought to reduce hospital admissions by incentivizing health care providers to invest in outpatient care. The initiative was focused on reducing readmissions for common conditions such as heart attacks, pneumonia and heart failure, and was implemented in 2012. The initiative involved the reduction of Medicare payments for hospitals with high readmission rates.
The federal law involved in this regulatory issue is the Patient Protection and Affordable Care Act (ACA) of 2010, which includes several provisions aimed at improving healthcare quality and controlling costs. One of the key provisions of the ACA is the Hospital Readmissions Reduction Program (HRRP) which seeks to reduce the readmission rate by adjusting Medicare reimbursements. The HRRP was implemented in response to concerns about the high rate of preventable hospital readmissions, which increase healthcare costs and negatively impact patient outcomes. At the state level, the issue was addressed by the implementation of various Medicaid programs. However, the specific state will depend on the location of the healthcare facility.
The law was created in response to concerns about the high rates and associated costs of hospital readmissions. The HRRP was established as part of the ACA with the aim of reducing the number of hospital readmissions and improving the quality of care for patients. The law served as an incentive to healthcare providers to reduce their readmission rates, which had a significant impact on Medicare reimbursements.
The regulatory issues and trends in the healthcare industry have a significant impact on service providers, patients, and the cost of healthcare services. In the case of the HRRP, efforts to reduce hospital readmissions have potentially reduced the financial burden on both patients and healthcare payers. However, the initiative has also contributed to decreased hospital revenue, as hospitals with high readmission rates are penalized. The regulatory issues and trends in healthcare will continue to evolve as policymakers and industry leaders seek to promote healthcare quality while maintaining financial sustainability.
In conclusion, healthcare regulations and compliance issues impact the delivery of healthcare services. It is essential for medical students to have an understanding of the legal issues and policy changes that affect the healthcare industry. By analyzing and understanding the regulatory issues and trends, medical students can better prepare themselves for their careers in the healthcare industry.