Accountability in Healthcare | Assignment

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Running head: ACCOUNTABILITY IN HEALTH CARE
ACCOUNTABILITY IN HEALTHCARE
Name of Student
Name of University
Author note

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Response to question 1
HMO stands for health management organization which was targeted at improving
the level of patient centered care, through a comprehensive, coordinated multidisciplinary
care being given to the patients. Instead of fee-for-service system, the health management
organization established a system of advanced payments being taken from a particular
population with the contract of providing them a range of services on a monthly or an annual
basis. It is very interesting to understand that the idea of health management organization was
actually to limit the consumption of the health care services at a time and also to improve the
level of quality care at the same time. On the other hand, it is to be noted the ACO that stands
for Accountable Care Organization bought further transitions and transformations in the
health care system. It is critical to understand that the accountability management
organization started to incentivize the quality and the distinguished performances by the
employees (Maddox et al., 2017). The new system of accountable care organization have
various others forms of unique payment structures to motivate the clinicians and the assistant
staffs, to take shared, interpersonal risks to improve the quality of coordinated care.
Moreover, in the structure of accountable care organization, the patient rights are given more
importance and hence it is critical to note, that in an ACO, unlike a HMO, the patient can
participate in the decision making, acceptance or withdrawal of the clinical services.
a.
Health information technology plays a huge role in not only improving the quality of
the care but also in assisting the clinicians and the supportive staffs in delivering a safer and a
more comprehensive, satisfying medical, nursing and allied health care to the patients in the
health organization and health care institutions. Health information technology, in the last
decade has made a huge progress in terms of technology and the features, to bring about more
assistance and centricity to the patient care. Health information technology like electronic

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medical records and the electronic health records plus database management has
revolutionized the ways of document keeping. Accessibility to the electronic records have not
only helped the nurses and the other staffs improve their level of care and the level of patient
servicing but it has also added to the safe and ethical management of the admitted cases in the
health care institutions. Moreover, the use of electronic posters, electronic reminders has
improved the compliance of the health care staffs with the hand hygiene, medication
administration, wearing the protective personal equipment in accordance to evidence based
practice guidelines which is a huge problem in most of the hospitals and nursing homes
across the countries (Levy, Ream & Ho, 2019). The health information technology has
greatly added to the importance of improving the clinical pathways that are being formulated
to deliver a safe, coordinate, multidisciplinary care to the services. Electronic auditing is
another important contribution of the health information technology in the field of health care
that allows the supervisors and the nursing managers to improve the level of administration
and compliance of the team members.
Response to question 2
There are a range of benefits of a hospitals partnering up with the primary care
providers. Firstly, the referral system is vital to the increase in the influx of patients to the
bigger multispecialty health care organizations. The primary care providers such as the
community general practitioners and community nurses refers the patient with critical
conditions to the bigger, more advanced and resourceful hospitals that is an important
benefits. Secondly, the hospitals can collaborate with the primary care workers to provide a
more comprehensive care services to the community living people (Martin et al., 2018).
These services are health care camps, health promotion services, workshops and community
change project as well.

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a.
Bundling payments means the reimbursements provided by the health care providers
for a range of care services received by the patients, at an effective cost and affordable
expense. The problems pended by the fee-for-service payments where the clients have to pay
separately for each service being delivered by the hospital to address their conditions – was
addressed by bundled payments (Martin et al., 2018). The bundled payments solved the
issues posed by the capitation as well where a large amount of payment has to be paid by the
customers that are often very burdening and cost-effective. Pay-for-performance was another
important strategy that provides extra payments to the quality performers in the field of health
care and health services (Agarwal et al., 2020). The pay-for-performance has been shown to
improve motivation and performance in the employees.
Response to question 3
The center for Medicare and Medicaid services, with the value-based purchasing
program, provides incentives to the certain health care providers and organizations, which has
provided quality health care services to the Medicare beneficiaries and clients.
a.
Value-based purchasing programs affect the reimbursement to hospitals in a drastic
manner. If the quality of services delivered to the clients of Medicare and Medicaid services
is high, then the hospital is reimbursed properly and if not, then the law allows the value
based program to withhold the payments of the participating hospitals by almost 2 percent.
b.
The program is targeted at providing a more safe and quality care to the patients in the
hospitals. The quality of the range of services delivered by the hospitals to the clients, are

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made worth the value of it and in a way, it justifies the cost-effectiveness of the clinical care
procedures. Secondly, it also benefits the patients by improving the experiences gained
throughout their course of care and treatments received in the hospitals. The program is
aimed at improving the patient experience by eliminating the risks of medication incidents,
by improving transparency of the care procedures and through driving the health care
professionals for the adoption of the evidence based practice protocols. Hence, it can be said,
the program primarily benefits the patients and then, the hospitals through the delivery of
quality care to the patients.
c.
The outcomes such as the rate of healthcare-associated infections, mortality rates,
complication rates, patient safety, the hospital experience of the patients, process, cost
reduction and efficiency are measured by the value based programs. to understand the
performance of the hospital in terms of quality and efficiency.

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References
Agarwal, R., Liao, J. M., Gupta, A., & Navathe, A. S. (2020). The Impact Of Bundled
Payment On Health Care Spending, Utilization, And Quality: A Systematic Review:
A systematic review of the impact on spending, utilization, and quality outcomes from
three Centers for Medicare and Medicaid Services bundled payment programs. Health
Affairs, 39(1), 50-57.
Levy, A. E., Ream, K. S., & Ho, P. M. (2019). ICD-10 Coding of Type 2 Myocardial
Infarction and Myocardial Injury as It Relates to US Centers for Medicare &
Medicaid Services Value-Based Payment Programs. JAMA cardiology, 4(10), 1051-
1051.
Maddox, K.E.J., Sen, A.P., Samson, L.W., Zuckerman, R.B., DeLew, N. and Epstein, A.M.,
2017. Elements of program design in medicare’s value-based and alternative payment
models: a narrative review. Journal of general internal medicine, 32(11), pp.1249-
1254.
Martin, B. I., Lurie, J. D., Farrokhi, F. R., McGuire, K. J., & Mirza, S. K. (2018). Early
effects of Medicare’s Bundled Payment for Care Improvement (BPCI) program for
lumbar fusion. Spine, 43(10), 705.