HSA4140_MOD4_Guilefuss
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St. Petersburg College *
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Feb 20, 2024
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COMPLYING WITH MARCA
1
Complying with MARCA
Leah Guilefuss
St. Petersburg College
HSA4140 Strategic Management and Planning Professor Justin Hancock
February 11
th
, 2024
COMPLYING WITH MARCA
2
HSA 4140: Strategic Health Management and Planning
White Paper Worksheet
Student Name: Leah Guilefuss
Issue Definition and Background and Situation Description
Dr. Jane Doe has participated in quality initiatives, but nothing very formal, and she has not submitted any data. Without anything formal, and with the passing of MACRA as it is proposed, she will not be able to bill for Medicare services unless she changes her practice.
Some physicians have decided to be employed by larger group practices and have the impacts of MACRA dealt with at the group level.
Some physicians have decided to manage the quality data and report on their own.
Some physicians have decided to affiliate with an ACO and participate in alternative payment models that would comply with the MACRA guidelines.
Options Available to Dr. Jane Doe
Dr. Doe has decided not to become employed by a larger group, so based on your research with the options to comply with MACRA (and the information listed above), you will determine that she only has 2 choices. Below, please list the options, and pros and cons to each.
Option 1:
Some Physicians have decided to manage the quality data and reporting on their own.
Pros to option 1:
By Dr. Doe managing her own data, she has a physician who has better control over the data that is to be shared. This can help make her practice look better, because it minimizes
receiving penalty on the practice reimbursement. The other pro to this option is data quality is so important that it leads to increased patient satisfaction, and improved patient outcomes (Krylov, 2023). With this Dr. Doe has the better odds of increasing her patient satisfaction and patient outcomes.
Cons to option 1:
The major con to this option is that when physicians obtain their own data, they need to be
COMPLYING WITH MARCA
3
mindful of complexity in understanding the MARCA guidelines. With that being said Dr. Doe’s office will need to make sure they read over the guidelines to ensure they understand. With this, the lack of data being obtained and the getting the appropriate quality data captured (
Pros and Cons of Quality Data Management
, n.d.). Option 2:
Some physicians have decided to affiliate with an ACO and participate in alternative payment models that would comply with the MARCA guidelines.
Pros to option 2:
Affiliating with an ACO can help providers with managing costs, but still providing the best high-quality care to patients (
Accountable Care and Accountable Care Organizations
| CMS
, n.d.). Also, with ACO’s they work quickly to ensure that health data exchange run smoothly between providers. Cons to option 2:
The only con to this option is the data is no longer controlled by Dr. Doe, everyone has access and privacy is lost.
Dr. Doe's Proposed Strategy
Now Choose one of the options above as your recommendation:
Recommendation:
My recommendation is that Dr. Doe chooses some physicians who have decided to manage the quality data and report on their own.
Based on the Strategic Initiative that you chose, define a goal for the physician:
Goal:
To make sure her practice looks best and minimize the likelihood of receiving a penalty on the practice reimbursement by providing more precise data by self-reporting.
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COMPLYING WITH MARCA
4
Based on the Goal that you chose, define at least 3 objectives:
Objective:
Putting a system into place within the next 2 months to ensure accurate data collection
Objective:
Controlling a privacy leak, every month during data sharing by doing the self-reporting Objective:
Providing accurate data, every month to show the offices best quality of services to get the max reimbursement. Measurement Criteria: Below, list at least 3 measurement criteria.
1.
Electronic Health Record
2.
Health Surveys 3.
Data Quality improvement programs Barriers and Constraints: Below, list at least 2 potential barriers and constraints.
1.
Incomplete records 2.
Inaccurate data collection
COMPLYING WITH MARCA
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References
Accountable Care and Accountable Care Organizations | CMS
. (n.d.). https://www.cms.gov/priorities/innovation/key-concepts/accountable-care-and-
accountable-care-organizations
Krylov, A. (2023, September 14). The value and importance of data quality in healthcare. Kodjin
- Turn-key FHIR Server for Healthcare Data
. https://kodjin.com/blog/the-value-of-data-
quality-in-healthcare/#:~:text=It's%20important%20to%20have%20quality,care%2C
%20and%20improved%20patient%20outcomes.
Pros and Cons of Quality Data Management
. (n.d.). Authorea. Retrieved February 13, 2024, from https://www.techrxiv.org/users/692786/articles/683126-pros-and-cons-of-master-
data-management#:~:text=The%20pros%20include%20elimination%20of,management
%2C%20and%20getting%20appropriate%20tooling.
Health Services Administration Assignment Grading Rubric
Component:
Content Unacceptable Marginally Meets
Expectations
Meets
Expectations
Exceeds Expectations
Maximum
Points
Points
Earned
COMPLYING WITH MARCA
6
Demonstrates accurate understanding and synthesis
of assignment concepts by:
Meeting content standards
Identifying relevant points
and main ideas that are organized and complete
Providing accurate and relevant information highlighting an understanding of material
Demonstrating original thought and personal reflection in relation to the
concepts
Providing evidence to support thoughts, comments and opinions (e.g., source citations)
Content does not meet assignment standards
Information provided was inaccurate
Information presented in disorganized manner
Information presented in an incomplete manner
Demonstrates limited understanding of the material
No supportive evidence provided
Provides insufficient peer-reviewed resources (citations and references)
Demonstrates limited or no original thought and/or reflection
Content marginally meets assignment standards
Information presented
was generally accurate
Information presented
is minimally developed
Content presented in a
disorganized manner
Information presented
demonstrates only partial understanding of the material
Information is insufficiently supported with up-to-
date, peer-reviewed resources
Demonstrates some original thought and/or reflection
Content sufficiently meets all assignment
standards
Information presented is accurate
Information presented is adequately developed
Content presented is organized
Information presented demonstrates an adequate understanding of the
material
Information is adequately supported with up-
to-date, peer reviewed resources
Demonstrates original thought and reflection
Content exceeds all assignment standards
Information presented exceeds expectations of upper division course work
Information presented is well developed
Content presented is exceptionally well organized and comprehensive
Information presented demonstrates thorough understanding and application of the material
Information is thoroughly supported with up-to-date, peer reviewed resources
Demonstrates original thought and insightful connections
14
Component:
Professionalism
Unacceptable
Marginally Meets
Expectations
Meets Expectations
Exceeds Expectations
Maximum
Points
Points
Earned
Demonstrates a commitment to academic integrity and professional standards by:
Meeting all assignment requirements completely
Maintaining academic integrity
Applying instructor feedback, when appropriate
Submitting work that is accurate and reflective of upper level scholarly expectations
Using professional language and terminology
Submitting work on time
Assignment requirements were not met
Did not adhere to principles of academic integrity
Work does not reflect correction of errors previously noted by instructor
Excessive errors in grammar, spelling, punctuation, and/or APA
Excessive use of unprofessional language, terminology or abbreviations (i.e. texting)
Key requirements of the assignment were missing
Adhered to principles of academic integrity
Works reflects only minimal correction of
errors previously noted by instructor
Numerous errors in grammar, spelling, punctuation, and/or APA
Some use of unprofessional language, terminology or abbreviations (i.e. texting)
Key requirements of the assignment were met
Adhered to principles of academic integrity
Works reflects correction of the majority of errors previously noted by instructor
Minimal errors in grammar, spelling, punctuation, and/or APA
Language and terminology is professional and appropriate
Key requirements of the assignment were met
Adhered to principles of academic integrity
Works reflects correction of all errors previously noted by instructor
Accuracy with grammar,
spelling, punctuation, and/or APA
Exceptional use of professional language and terminology
6
Total Points
20
Instructor
Feedback
Special Disclaimers:
1 point deduction for failure to use standard HSA file naming convention: course_assignment_lastname
(i.e. HSA3104_timeline_smith)
1 point deduction for failure to include the assignment rubric.
Abbreviated Late HSA Policy, please see your course syllabus for the full late policy:
Assignments submitted within 24 hours of due date –
50% deduction (graded score – 50%).
Assignments submitted after 24 hours are not accepted for credit.
Academic Integrity:
All academic work submitted to satisfy course requirements is expected to be the student’s OWN work. All instances of plagiarism
will be
forwarded to the Dean for review and possible academic discipline.
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