PowerPoint Presentation: Narrative Presentation to the Board of Trustees
The Centers for Medicare & Medicaid Services (CMS) has taken on a more visible role in health care. A great deal of change has transpired to improve patient safety and implementation of additional quality metrics.
The new health care reform has begun to change the fees/structure of Medicare and Medicaid reimbursement for health care services.
For this assignment, write a narrative presentation that you will deliver to the members of your organization’s board of trustees on how the new reimbursement structure will impact the organization’s revenue structure. In your presentation, address the following questions:
•Why did CMS become more involved in the reimbursement component of health care? How does this involvement impact health care organizations?
•What tools can be implemented to ensure that an organization is meeting the policies and procedures set forth by CMS?
•Identify three tools from the Centers for Disease Control and Prevention website that are helpful to achieving the goals set forth by your organization.
http://www.cms.gov/
To create a narrative presentation on how the new reimbursement structure will impact your organization's revenue structure, you should start by conducting research and gathering relevant information. Here's how you can approach each question in your presentation:
1. Why did CMS become more involved in the reimbursement component of healthcare? How does this involvement impact healthcare organizations?
To answer this question, you'll need to understand the reasons behind CMS's increased involvement in healthcare reimbursement. Start by conducting research on the historical context and policy changes that led to this increased involvement. Consider factors such as rising healthcare costs, the need for improved patient safety, and the desire to implement quality metrics. These factors have driven CMS to take a more active role in healthcare reimbursement.
To explain the impact on healthcare organizations, research the current reimbursement structure and the changes brought about by healthcare reform. Look for data on how these changes are affecting reimbursement rates and overall revenue in the industry. Analyze case studies and existing literature to highlight the specific challenges and opportunities these changes present to your organization.
Additionally, consider the potential benefits that CMS's increased involvement may bring, such as standardized reimbursement criteria, improved patient outcomes, and increased accountability.
2. What tools can be implemented to ensure that an organization is meeting the policies and procedures set forth by CMS?
CMS sets specific policies and procedures that healthcare organizations must follow to ensure compliance and eligibility for reimbursement. Here are some steps to help identify and explain the tools used to meet CMS requirements:
a) Research CMS guidelines: Familiarize yourself with the policies and procedures outlined by CMS. Visit the CMS website and access resources such as the Medicare Learning Network and the CMS Provider Enrollment, Chain, and Ownership System (PECOS). These resources provide detailed information about compliance requirements.
b) Conduct internal assessments: Evaluate your organization's existing policies and procedures against CMS guidelines. Identify any gaps or areas where improvement is needed. This can include reviewing billing processes, documentation requirements, and quality assurance programs.
c) Implement electronic health record systems: Utilize electronic health record systems to streamline documentation and ensure accurate reporting. These systems can help with data collection, coding accuracy, and compliance with CMS requirements.
d) Establish compliance programs: Develop and implement compliance programs to ensure adherence to CMS regulations. These programs should include regular training sessions for staff on documentation, coding, and compliance requirements.
e) Utilize quality improvement initiatives: Engage in quality improvement initiatives to enhance patient outcomes and meet CMS quality metrics. Examples can include participating in CMS quality reporting programs such as the Merit-based Incentive Payment System (MIPS) or utilizing clinical decision support tools to improve care delivery.
3. Identify three tools from the Centers for Disease Control and Prevention (CDC) website that are helpful to achieving the goals set forth by your organization.
To identify three tools from the CDC website that align with your organization's goals, follow these steps:
a) Identify your organization's goals: Determine the specific objectives and targets your organization aims to achieve. This can include reducing healthcare-associated infections, improving immunization rates, or enhancing chronic disease management.
b) Research CDC resources: Explore the CDC website to find resources related to your goals. For example, if your goal is to reduce healthcare-associated infections, go to the CDC's Healthcare-Associated Infections page and look for tools such as the National Healthcare Safety Network (NHSN) or the CDC's Guidelines for Isolation Precautions.
c) Select three relevant tools: Choose three tools or resources from the CDC website that align with your organization's goals. Ensure that these tools provide evidence-based guidelines, best practices, or data that can support your organization's efforts. Explain how each tool can be utilized to improve patient outcomes and achieve your organization's objectives.
Remember to provide concrete examples and supporting data in your presentation to engage the board of trustees and demonstrate the potential impact of the new reimbursement structure on your organization's revenue structure.