Read the scenario that you will use for the Individual Projects in each week of the course. The Centers for Medicare and Medicaid Services (CMS) has taken on a more visible role in health care delivery. Many changes have transpired to improve patient safety along with the implementation of additional quality metrics, and these changes impact reimbursement rates.
Likewise, the Patient Protection and Affordable Care Act has changed the reimbursement fee structure of Medicare and Medicaid reimbursement for health care services. Other legislation including the HITECH Act and the Medicare Authorization and CHIP Reactivation Act of 2015 (MACRA) all impact how healthcare organizations receive reimbursement and demonstrate use of data to improve quality and delivery of patient care.
Mr. Magone, CEO of Healing Hands Hospital, has asked you to join the “Future of Healing Hands” Task Force. Your first assignment is to work with the Hospital Chief Financial Officer, Mr. Johnson, and provide a summary of the current regulations regarding Medicare reimbursement including how MACRA will impact reimbursement if/when Healing Hands coordinates delivery of services by affiliating with physician practices.
For this assignment, write a 2-page report, not including the title page and reference page, on how the new CMS initiatives and regulations will impact the organization’s revenue structure. The HCM Learning Center page for this class has excellent resources for more information within the Unit 1 tab. This is Section 1 of your report to the Task Force. This first section should be titled “Impact of CMS Regulations and Reimbursement Models”. In your report include:
Be sure to include at least two reference sources and cite them using APA formatting.