Brainstorming Case Study

The Texas Health and Human Services Commission (HHSC) is required by federal law to ensure federally qualified health centers (FQHCs) are reimbursed no less than their Prospective Payment System (PPS) rate for services provided in the Medicaid and CHIP programs (42 U.S.C. 1396a).

The article empowering patients to become better healthcare partner references this thought process. The article says with the increase of newly insured patients into the healthcare system hospitals need to find ways to save money. Some hospitals are looking at partnering with patients on their care outside of their appointment. HG Clinic used patient’s suggestions to implement the e-statement options empowering patients to be involved in their decisions. Patients could continue to be used to assist with their care and services. (2015,

Advance Payment Account Care Organization Model which focuses additional support to physician owned and rural providers participating in the Medicare Shared Savings Program by providing start-up resources to build better infrastructures throughout. The shared savings which the Accountable Care Organization (ACO) would be split in half and given back to the organization which provided the savings. In other words, in the case of my hometown hospital, if an ACO would take over and re-open our hospital, the predictions are that by retrieving these savings which are provided for by Obama-care, and by right-sizing our hospital from a 45 bed hospital to a 10 bed hospital and right-sizing the amount of employees, we would be back in the black within a 2 year period. That is a major step in financing this hospital to continue servicing a major part of the community which needs major health care to continue.

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The individual mandate, a shared responsibility in the Affordable Care Act, requires all Americans to have health insurance. (42 U.S.C., 2010) This new law highlighted a gap in the Medicaid coverage leaving

Accountable Care Organizations – “ ‘National Pilot Program On Payment Bundling’ - The Secretary shall establish a pilot program for integrated care during an episode of care provided to an applicable beneficiary around a hospitalization in order to improve the coordination, quality, and efficiency of health

Supporters of this policy include key federal and state stakeholders. The federal government through the Affordable Care Act (ACA) offers financial incentives for state policies that improve patient safety and reduce medical adverse events by implementing plans aimed at those issues. Those states that show improvement and reductions will receive 5-year grants. Also, The ACA has established accountable care organizations (ACOs) to manage the improvement of patient quality health care by offering hospitals financial incentives for hospital that report their performances. U.S. Department of Health and Human Services is a federal agency responsible for the “health of all Americans” and human services provisions. It is also a large

Healthcare reform has created incentives to increase patient engagement to increase accountability, healthcare outcome and lower healthcare cost. In the early days of this movement, web portals were created with basic functions of requesting appointments, prescription refills, and paying medical bills (Butterfield, 2013). Today, patient portals allow users to access dictated visit reports, labs, approve access controls combined with the function of the web portals. As more health information is pushed to the portals, the users (patients and family) are more involved with healthcare decisions and more knowledgeable on available options that meet individual need.

Indian Health Services (IHS) is federally a part of Department of Health and Human Services (HHS), Erected in 1921 and headquartered in Rockville, Maryland. IHS mission is to raise the physical, mental, social, and spiritual health of Native Americans and Alaska

In order to reach the program’s goal, the program needs to provide better care for individuals, better health for populations, and lowering growth in expenditures. There are 433 Shared Savings Program. The Advance Payment ACO Model is a supplementary incentive program for selected participants in the Shared Savings Program designed by the Innovation Center. This program is meant to help smaller ACO’s with less access to capital participate in the Shared Savings Program. Like the name of this program, this ACO gets advance payments that will be repaid from the future shared saving they earn. According to the Center for Medicare and Medicaid Services, the Advance payment ACO Model will test whether providing an advance through up-front and monthly payments that will be repaid in the future will increase participation the Shared Savings Program and whether advance payments will allow ACOs to improve care for beneficiaries, increase the amount of Medicare savings, and create Medicare savings more

The Director’s office is the head of the whole department. It is the director’s duty to advocate for public’s health in Iowa and to act as the spokesperson to local health boards, public health agencies, local health care providers, and also consumers of health care services. The director works hand in hand with local, state, national, and international policymakers. The six divisions contained in the IDPH are; the Iowa Board of Medicine, the Iowa Board of Nursing, the Office the State Medical Examiner, the Iowa Dental Board, the Iowa Board of Pharmacy, and last but not least the State Board of Health (Des Moines 19).IDPH is averaged to be about 1.7 million dollars. According to their annual report, they spent 1.72 million dollars in 2013 which was lower compared to the amount spent in 2014 which amounted to about 1.81 million dollars (Darling et al.

All hospitals on Native American reservations are run by the Indian Health Services or IHS for short. The IHS is an agency within the Department of Health and Human Services. The responsibility of the department is to provide “federal health services to American

In order to contain health care cost, expand access to care, and improve the nation’s health. The Affordable Care Act requires certain regulations in order to coordinate Medicare patients through Accountable Care Organizations. The first one is ACOs must have formal legal structure to receive and distribute shared saving. For example, The Centers for Medicare and Medicaid Services work with other health agencies in order to facilitate shared savings. Secondly, each ACO must have enough primary care professionals employed in order to treat their population. Third, each ACO must have agree to participate in the program for 3 years, as well as have enough information regarding health care professionals who are participating under the ACO. Moreover, ensure leadership and management structure that includes clinical and administrative systems. Promote evidence-base medicine and report the data to evaluate quality and cost measures. Lastly, the organization must prove that it is meeting the patient-centeredness criteria. An ACO must also have the ability to identify the best practices that deliver the best care and reduce cost within the organization. In addition, ACO must work with the community to provide resources to patients in order to improve he overall health of the

The Texas Health and Human Services Commission oversees the operations of the health and human services system: Health and Human Services Commission (HHSC), Department of Aging and Disability Services (DADS), Department of State Health Services (DSHS), Department of Assistive and Rehabilitative Services (DARS), and Department of Family and Protective Services (DFPS). It provides administrative oversight of Texas health and human services programs: Medicaid, Children 's Health Insurance Program (CHIP), Texas Women’s Health Program, Temporary Assistance for Needy Families, SNAP Food Benefits and Nutritional Programs, Family Violence Services, Refugee Services, and Disaster Assistance. The organizations goal is to

Since this passage of new treaties and laws, many Supreme Court decisions have been passed. The IHS offers comprehensive health coverage for approximately 1.9 million American Indians and Alaska natives who belong to 564 federally recognized tribes in 35 states (Definition of Indian Health Service Definition 2012). The federal system consists of 29 hospitals, 68 health centers and 41 health stations (Definition of Indian Health Service Definition 2012). There are 33 urban Indian health providers in a variety of health and referral services (Definition of Indian Health Service Definition 2012). All 29 IHS operated hospitals are accredited by the Joint Commission or Certified by the Centers for Medicare and Medicaid Services (Definition of Indian Health Service Definition 2012).