Question

Long-Term Care Reimbursement The federal and state governments are the largest payers of health care services in the United States. The largest federal programs are the Medicare and Medicaid services. Using the information from the textbooks, lectures, and Internet resources, provide a brief summary of Medicare and Medicaid services in a Microsoft Word document. To get up-to-date information on the programs, review the information shared on the following websites: The Centers for Medicare and Medicaid Services The Social Security Administration In your summary, include the following points: An overview of the different Medicare and Medicaid services The population covered under Medicare and Medicaid services The services of long-term care covered under Medicare and Medicaid, including the restrictions placed on them

REFERENCE:

Title:Long-Term Care: Managing Across the Continuum
Author: John Pratt
Edition/Year: 4th Ed./2016
Publisher: Jones & Bartlett
ISBN: 978-1-284-05459-0

Answer 1

The necessity for quality and safety improvement initiatives permeates health care 1, 2 Quality health are is defined as 'the degree to which health sources for indwluals and populations increase the likelihood of desired health outcomes a. are consistent with current professional knowledge7 (p 1161) According to the Institute of Medicine QOM) report To Err Is 1-luman4 the maggoty of medical errors result from faulty systems and praesses, not indwluals Pcxesses that are inefficient and variable, changing case mix of patients, health insurance, differences in prouder education and experience, a. numerous other factors contribute to the complexity of health care With this in mind, the 10M also asserted that t.ay, health care industry fictions at a lower level than it can and should, and it put forth the following six aims of health care effective, afe, patent-centered, timely, efficient, a. equitable The aims of effectiveness a. safety are targeted through process-of-care measures, assessing whether prowlers of health care perform praesses that have been demonstrated to achieve the desired aims a. avoid those processes that are predisposed toward harm The goals of measuring health care quality are to determine the effects of health care on desired outcomes and to assess the degree to which heal. care adheres to presses based on scientific endence or agreed to by professional consensus an. consistent math patient preferences

Because errors are caused by system or process failures5 it is important to adopt various process-improvement techniques In tdentrty tneffictenoes tnellechve care. a. preventable errors to then incidence changes associated mth systems Each al these techniques involves assessing performance and using findings to inform change 'Ns chapter mll Stacks statists a. tools for quality improvement—including failure modes and effects analysts Plandle•StudyAct Six Sigma, Lean, and root-cause analysis—that have been used to improve the nualny and safety of health care

Measures and Benchmarks

Go to Top, Efforts to improve quality need to be measured to demonstrate 'whether improvement efforts (1) lead to change in the prima, end point in the desired direction, (2) contribute to unintended results in awe. parts of the system, and (3) require additional efforts to bring a process back into acceptable ranges.° 5). 735) The rationale for measuring quality improvement is the belief that good performance reflects good-qualtly practice, and that comparing performance among prowiers and organizations will encourage better performance In the past few years, there has been a surge in measuring and reporting the performance of health care systems and processes 1, 7-g While public reporting of quality performance can be used to identify areas needing improvement and ascribe nMional, State, or other level of benchmarks,10, 11 some prowlers have been sensitive to comparative performance data being published 12 Another audience for public reporting, consumers, has had problems interpreting the data in reports and has consequently used the reports to the extent hoped to make informed decisions for higher-quality care 1,15