Reimbursement from government payers

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The advent of the Affordable Care Act has also placed a priority on quality care in lieu of payment for quantity of care. As the focus shifts financially QUALITY and VALUE has become the new industry buzz word. As consumers become more savvy and involved in their health choices quality and reporting plays a big role. At the end of 2014 the US government announced that 724 hospitals would be penalized with a 1% reduction over 300 million in reimbursement from government payers (Medicare / Medicaid etc.) for lacking quality (Blesch, 2014).

TQM is one type of quality improvement model and the focus of this week's lecture. Unlike many models Total Quality Management seeks to address proactively quality and performance prior to events or other negative outcomes. Today most health organizations focus their quality activities on those items that are being reported especially when money is tied as an incentive. This reactive model may miss important opportunities for improvement by overly focusing on "key indicators".

This week utilize your own practical experience (even as a patient) and scholarly literature to proactively identify a TQM project which you could proactively identify and critically analyze the following:

  • The TQM model from the lecture - categorize your TQM project and apply the 3 steps
  • Locate reliable benchmarks to support your project control function
  • Outline your managerial process for conducting the project - include the six steps planning, staffing, etc.
  • In your final paragraph critically evaluate and support why this process improvement will result in quality improvement and aligns with the strategy of the organization and the health care industry

Reference no: EM131641607

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