Running head: M5A1: Analyzing the Regulatory Impacts of Health Care Reform 1

M5A1: Analyzing the Regulatory Impacts of Health Care Reform

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Excelsior College
M5A1: Analyzing the Regulatory Impacts of Health Care Reform 2

Analyzing the Regulatory Impacts of Health Care Reform

The Affordable Care Act has changed the landscape of healthcare in America. Hospital

reimbursements have changed from volume to value. With reimbursements linked to patient

outcomes, it is imperative that health care organization accept the recommendations given by the

regulatory agencies. The Joint Commission (TJC) and The Centers for Medicare & Medicaid

Services CMS are working to ensure that health organizations are meeting the needs of the

patient through increased regulations.

The Joint Commission has embarked on creating greater accountability on emergency

departments with a three-year initiative. Transition of care is an area of concern as studies have

shown that errors have a tendency of occurring due to “omissions or misunderstandings often

lead to adverse outcomes or readmissions, so improvements have the potential to boost outcomes

and reduce costs and inefficiencies” (Clark & Duco,2012). CMS also strives to ensure

successful patients outcomes by linking them to reimbursements.

A Regulatory impact on healthcare by CMS and TJC is the are enforcement of the flu

vaccination on health care providers and transition of care of patients leaving healthcare

facilities. The Centers for Medicare & Medicaid Services (CDC) has accepted the

recommendation provided by The Centers for Disease Control and Prevention’s National

Healthcare Safety Network (NHSN). The NHSN’s Advisory Committee on Immunization

Practices (ACIP), recommends that healthcare professionals should receive the vaccine annually

(CDC, 2015). The study conducted by the ACIP indicates healthcare providers who obtain the

flu vaccination reduces the risk of absenteeism and “with fewer deaths among nursing home

patients and elderly hospitalized patients” (ED Management, 2012). The Joint Commission has

“set incremental vaccination goals that get them to a 90% vaccination rate by 2020. The Joint
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Commission expects healthcare organizations to perform the following:establish an annual

influenza vaccination program that includes all staff and licensed independent practitioners;

 provide influenza vaccinations on site;

 monitor vaccination rates as well as the reasons why staff decline to be vaccinated;

 implement regular enhancements to the program to improve vaccination rates;

 provide education about influenza and its potential impact, including information about

vaccination as well as other methods for controlling the spread of the virus (ED

Management, 2012).

Another regulatory impact set by TJC and CMS is the transition of care of patients from a

health care facility. The Joint Commission is working to create processes and standards to

prevent communication breakdown between healthcare facilities. The accreditation program

seeks to hold hospitals accountable on how they manage patient care. While the Joint

Commissions has standards regarding discharge and patient education. The are looking to

improve those standards to ensure the safety of patients. The survey will be designed to help

accredited “organizations with transitioning and transferring patients to the next care setting”,

whether that is home or another health care organization” (ED Management, 2012). The Center

for Medicare & Medicaid Services added three additional questions to provide greater

transparency of the discharge process that will assist to reduce readmissions. The three Care

Transition questions considered part of the HCAHPS Core questions” (Centers for Medicare &

Medicaid Services, 2012, p.6).

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The ethical consideration raised by the regulatory agencies allows patients to obtain the best

care possible by holding health care organizations accountable for patient outcomes. With

reimbursements linked to successful patient outcomes health care leader should ensure any

patient seeking treatment receives it. To respond with empathy, urgency and without prejudice to

the needs of the patients and their families.

Healthcare managers can assist their organizations with the implementation of the standards

set forth by CMS and TJC by seeking best practices. Instead of terminating staff for not

adhering to flu vaccination policy work to implement processes to avoid direct patient contact or

the ability to wear a mask when treating patients. Explain to staff the importance of the flu

vaccination when taking care of patients with comprised immune systems.

Healthcare managers should look to the patient discharge process as an opportunity to impact

patient readmissions and look to enhance patient education. Train staff on the teach-back method

to ensure patients and their caregivers understand their follow-up care. Look to technology to

deliver discharge instructions possibly sending instructions to the patients phone or email

account. Include helpful videos regarding medication and side effects and allow patient and

caregiver to view after discharge. Perform discharge phone calls to patients to follow up after

care has been provided. Leaders should also look to staff for recommendations deferring to their

expertise.
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References

Centers for Disease Control and Prevention. (2015, July 30). ACH surveillance for healthcare

personnel vaccination | NHSN | CDC. Retrieved from http://www.cdc.gov/nhsn/acute-care-

hospital/hcp-vaccination/

Centers for Medicare & Medicaid Services. (2012, March). Quality Assurance Guidelines-

CAHPS® Hospital Survey (HCAHPS). Retrieved from

http://www.hcahpsonline.org/files/HCAHPS%20Quality%20Assurance%20Guidelines%20V7.0

%20March%202012.pdf

ED accreditation update: In a major three-year initiative, the joint commission puts transitions of

care under scrutiny. (2012). ED Management, , suppl 1-2. Retrieved from

http://search.proquest.com/docview/1170523728?accountid=134966

Zimlichman, E., Rozenblum, R., & Millenson, M. (2013, September). Israel Journal of Health

Policy Research | Full text | The road to patient experience of care measurement: lessons from

the United States. Retrieved from http://www.ijhpr.org/content/2/1/35