Question 3: This Is A Major Federal Agency That Provides Hea

Question 3this Is A Major Federal Agency That Provided Health Insuranc

This assignment involves identifying a major federal agency responsible for providing health insurance to U.S. citizens aged 65 or older, maintaining extensive data on Medicare and Medicaid expenditures, as well as the Children’s Health Insurance Programs and national healthcare expenditures. Additionally, it requires explaining the roles of various groups in the healthcare value improvement process, evaluating strategic investment options for post-acute elderly care, analyzing the six IOM quality aims for safety improvements, and discussing key stakeholders in healthcare organizations with an example of motivating engagement.

Paper For Above instruction

The federal agency responsible for providing health insurance to U.S. citizens aged 65 and older, as well as managing data related to Medicare, Medicaid, and other health programs, is the Centers for Medicare & Medicaid Services (CMS). CMS is part of the U.S. Department of Health and Human Services and plays a pivotal role in administering major healthcare programs, collecting and analyzing expenditure data, and shaping health policy that impacts millions of Americans (CMS, 2020).

In the healthcare value improvement process, various groups have distinct and vital roles. The boards of directors establish the strategic direction and governance, ensuring organizational accountability and alignment with quality goals. Senior leaders execute organizational strategies, foster a culture of safety, and allocate resources effectively. Physicians serve as frontline providers, influencing care quality directly through clinical decision-making and patient interaction. Employees across all levels support daily operations and contribute to continuous improvement initiatives. Payers, including insurance companies and government programs, influence healthcare delivery by setting reimbursement policies and incentivizing quality and efficiency (Berwick & Shojania, 2016).

Given the increasing number of elderly patients discharged from hospitals after procedures like knee and hip replacements, strategic planning for post-acute care facilities is essential. Investing in rehabilitation centers or skilled nursing facilities (SNFs) offers the highest strategic value in this context. These facilities provide specialized intensive rehabilitation services crucial for improving patient outcomes and expediting recovery. They also align with the healthcare system’s shift toward value-based care, emphasizing patient-centered outcomes and efficient recovery pathways (Naylor et al., 2011). These investments support seamless transitions of care, reduce readmission rates, and enhance overall patient satisfaction, making them a judicious choice from a strategic perspective.

In 1999, the Institute of Medicine (IOM) published "To Err Is Human: Building a Safer Health System," setting the foundation for patient safety and quality improvement. The six IOM aims for quality improvement are: safety (reducing harm to patients), effectiveness (providing services based on scientific knowledge), patient-centeredness (care respectful of individual preferences), timeliness (reducing delays), efficiency (avoiding waste), and equity (ensuring care equitable across populations) (IOM, 1999). These aims serve as guiding principles to develop safer, more effective, and equitable healthcare systems that focus on continuous improvement of patient outcomes.

Key stakeholders in a healthcare organization include patients, healthcare providers, payers, regulatory agencies, community members, and employees. Engaging stakeholders is critical for organizational success and sustainability. For example, motivating a stakeholder group such as healthcare providers might involve expressing how their commitment to quality directly impacts patient safety and satisfaction, for instance: "Your dedication to delivering evidence-based care ensures our patients recover faster and experience fewer complications, reinforcing our reputation as a trusted health provider."

References

• Berwick, D. M., & Shojania, K. G. (2016). Making healthcare safer: review of patient safety initiatives. Agency for Healthcare Research and Quality.
• Centers for Medicare & Medicaid Services (CMS). (2020). About CMS. https://www.cms.gov/about-cms
• Institute of Medicine (IOM). (1999). To Err Is Human: Building a Safer Health System. National Academies Press.
• Naylor, M., Aiken, L. H., Kurtzman, E. T., Olds, D., & Hirschman, K. B. (2011). The importance of transitional care in achieving health reform. Health Affairs, 30(4), 746-754.