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TopBackground
Health care expenditures have amplified melodramatically during the past 50 years, mutually in total terms and as a share of Gross Domestic Product (GDP) (Center for Medicare and Medicaid Services [CMS], n.d.). Expenditures in the U.S. health care segment computed over $2.7 trillion in 2011, increasing from up the $698.3 billion expended in 1980, increasing by a factor of 3.9. Health care expenditures in 2011 attributed for 17.9 percent of GDP, resulting in doubling of the shares from 1980 (CMS, n.d.). These expenditures have led to Quality Management for Health Care System to make available a structure to aid health organizations in communicating, monitoring, and incessantly advancing the whole HDS (James, n.d.). The vision for the Center for Medicare & Medicaid Services (CMS) Quality Strategy is to optimize health outcomes by leading clinical quality improvement and health system transformation. This has resulted in and gives indication back to the very suggestion that a systematized system to achieve high quality care can be a front-runner to lowering health care costs (James, n.d.).
Key Terms in this Chapter
Patient Protection and Affordable Care Act (PPACA): The health care interrelated portions of the Health Care and Education Reconciliation Act of 2010 and the Student Aid and Fiscal Responsibility Act were also affirmed into law end to end with the PPACA. These Acts seek to overhaul the current healthcare system. “ObamaCare” H.R. 3590, or Affordable Care Act (ACA) for short turned out to be the largest renovation to healthcare reform since Medicare/Medicaid which was signed into law in 1965(Obamacare Facts, n. d.).
System of Records Notices (SORNs): “Required health organizations to create and maintain SORNs. “A system of records consists of any item, collection, or grouping of information about an individual, where those records can be retrieved by the name of the individual or by some other type of identifier unique to the individual” (HHS, n. d.).
Health Insurance Portability and Accountability Act (HIPA): Act created by the U.S Congress in 1996 that amends both the Employee Retirement Income Security Act (ERISA) and the Public Health Service Act (PHSA) in an effort to protect individuals covered by health insurance and to set standards for the storage and privacy of personal medical data.
Health Information for Economic and Clinical Health (HITEACH) Act of 2009: Requires certified Electronic Health Records (EHR’s). This requires providers to commit continued use of EHR technology over a period of years. There are no measurable thresholds and programmatic timelines (Joseph, Sow, Furukawa, Posnack, & Chaffee, 2014). However, the certification process for EHR vendors has reduced provider uncertainty by establishing an unbiased validation service to ensure that certain functionality is available. Providers have to meet certain criteria of “meaningful use”. To an extent that has put the market and not the federal government in determining the vendors that will meet the provider needs with the financial incentives (Joseph, et al., 2014).
Privacy Act of 1974: This act “protects records that can be retrieved by personal identifiers such as a name, social security number, or other identifying number or symbol” (HHS, n. d.).
Clinical Effectiveness: Application of interventions which have been presented to be effective to appropriate patients to improve patients' outcomes and value for the use of resources (National Institutes of Health, Health & Human Services, 2014 AU66: The in-text citation "Health, Health & Human Services, 2014" is not in the reference list. Please correct the citation, add the reference to the list, or delete the citation. ).
American Recovery and Reinvestment Act (ARRA): Had three immediate goals: to create new jobs and save existing ones, to spur economic activity and invest in long-term growth and to foster more accountability and transparency in government spending (Blumenthal, 2010).
Gross Domestic Product (GDP): Represents the monetary value of all goods and services produced within a nation's geographic borders over a specified period of time.