Prepare Review Of Healthcare Policy Resources

To Prepare Review The Resources On Healthcare Policy And Regulatoryle

To prepare: Review the Resources on healthcare policy and regulatory/legislative topics related to health and nursing informatics. Consider the role of the nurse informaticist in relation to a healthcare organization’s compliance with various policies and regulations, such as the Medicare Access and CHIP Reauthorization Act (MACRA). Research and select one health or nursing informatics policy (within the past 5 years) or regulation for further study. As a professional nurse, you are expected to apply your expertise to patient care.

On occasion, you will also be expected to share that expertise. With evolving technology and continuous changes to regulations designed to keep up these changes, there is usually a need to share information and expertise to inform colleagues, leadership, patients, and other stakeholders. In this assignment, you will study a recent nursing informatics-related healthcare policy, and you will share the relevant details via a fact sheet designed to inform and educate.

The assignment involves creating a 1-page fact sheet, which your healthcare organization could hypothetically use to explain the selected health or nursing informatics policy/regulation. Your fact sheet should address the following:

• Briefly and generally explain the policy or regulation you selected.
• Address the impact of the policy or regulation on system implementation.
• Address the impact of the policy or regulation on clinical care, patient/provider interactions, and workflow.
• Highlight organizational policies and procedures that are or will be in place at your healthcare organization to address the policy or regulation. Be specific.

Use APA format, including a title page, in-text citations, and references. Use SafeAssign drafts to check your match percentage before submitting your work.

Paper For Above instruction

In recent years, healthcare policies and regulations have significantly evolved to improve patient outcomes, ensure data privacy, and promote quality-based reimbursement models. Among these policies, the Medicare Access and CHIP Reauthorization Act (MACRA), enacted in 2015 and effective from 2017, stands out as a transformative legislation aimed at shifting healthcare reimbursement from traditional fee-for-service to value-based care. MACRA incentivizes healthcare providers, including nurses and nurse informaticists, to improve care quality while controlling costs by rewarding optimal performance through the Quality Payment Program (Centers for Medicare & Medicaid Services [CMS], 2018).

Overview of MACRA

MACRA's primary goal is to accelerate the transition to value-based care by creating a standardized framework that assesses healthcare providers’ performance based on quality, resource use, clinical practice improvement activities, and advancing care information. The legislation replaced the Sustainable Growth Rate (SGR) formula, offering a more sustainable and outcome-oriented reimbursement model (HealthIT.gov, 2018b). It emphasizes the implementation of health information technology (health IT) systems that facilitate meaningful use of electronic health records (EHRs), data sharing, and care coordination.

Impact on System Implementation

Implementation of MACRA requires healthcare organizations to adopt advanced health IT systems capable of capturing comprehensive clinical data, supporting performance measurement, and reporting. The compliance necessitates the integration of interoperable EHR systems, certified under the ONC Health IT Certification Program, which can seamlessly exchange data across different care settings (HealthIT.gov, 2018a). This expected shift enhances documentation accuracy, improves data analytics capabilities, and supports real-time decision-making. However, it also demands significant investment in infrastructure, staff training, and ongoing system upgrades to meet MACRA’s requirements and ensure accurate reporting (McGonigle & Mastrian, 2022).

Impact on Clinical Care, Patient/Provider Interactions, and Workflow

MACRA encourages clinicians to focus on patient-centric, evidence-based care, which can improve clinical outcomes and patient satisfaction. The policy promotes the utilization of EHRs and clinical decision support tools, fostering better communication between providers and patients. These systems streamline documentation and reduce redundant tasks, allowing clinicians to spend more time on patient interaction. Nevertheless, the transition period may initially increase administrative burden and alter workflow patterns, potentially leading to provider burnout if not managed properly. Effective change management strategies and user-friendly EHR interfaces are critical to mitigating these challenges (McGonigle & Mastrian, 2022).

Organizational Policies and Procedures

To address MACRA's requirements, healthcare organizations typically develop comprehensive policies that establish protocols for data collection, security, and reporting. For example, organizational procedures may include regular training sessions on meaningful use, data privacy, and system updates, as well as establishing performance dashboards for continuous quality improvement. Additionally, organizations may designate compliance officers and employ clinical informaticists to oversee adherence to MACRA metrics and facilitate staff engagement with new workflows (Centers for Medicare & Medicaid Services, 2018). These policies serve as proactive measures to ensure regulatory compliance, optimize reimbursement, and enhance overall care quality.

Conclusion

MACRA's implementation represents a paradigm shift toward value-based care, with significant implications for health IT infrastructure, clinical workflows, and patient outcomes. The role of the nurse informaticist becomes crucial in guiding the integration of compliant systems, analyzing performance data, and fostering a culture of continuous improvement. As healthcare organizations adapt to this evolving landscape, strategic policies and informed staff engagement are essential for success.

References

• Centers for Medicare & Medicaid Services. (2018). MACRA. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-and-MIPS
• HealthIT.gov. (2018a). Health IT legislation. https://www.healthit.gov/topic/health-it-legislation
• HealthIT.gov. (2018b). Meaningful use and MACRA. https://www.healthit.gov/topic/meaningful-use-macra
• McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.