The new regulations that have been imposed, together with further regulatory changes that have been proposed. By the Centers for Medicare and Medicaid Services (CMS) are motivated by several objectives. The first objective is to improve the quality of patient care outcomes. This approach may appear at first glance to be counter-intuitive, as decreasing or restricting provider reimbursement would not seem to be the best way to motivate providers to provide better patient care. In fact, however, the new restrictions on reimbursements is a punitive action against providers who in the past have been reimbursed for problems that were under the control of the healthcare provider to prevent, such as falls in the hospital, treatment and medication errors, and so forth. Healthcare delivery organizations also are in line for benefits from the regulatory changes, because under the pay-for-performance protocol a number of initiatives reward providers for high quality patient care (Schindler, 2009). Many healthcare provider organizations are monitoring the ongoing debate of healthcare reform in the Congress. These organizations, however, should also pay close attention to the statements of the Obama Administration and the CMS, because the president has the authority under existing legislation to require an increase in the use of information technology by healthcare organizations (Chugh, 2009). The use of regulatory power and the issuance of regulatory guidance can further affect the operations of healthcare delivery organizations and the reimbursement schemes upon which such organizations rely.
Chugh, M. (2009, Fall). Executive authority to reform health: Options and limitations. Journal of Law, Medicine & Ethics, Supplement 2, 37, 20-37.
Schindler, D. S. (2009, Spring). Pay for performance, quality of care and the revitalization of the False Claims Act. Health Matrix: Journal of Law Medicine, 19(2), 387-422.
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