HSA4140_MOD4_Guilefuss

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St. Petersburg College *

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4140

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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 5 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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