Center for Medicare and Medicaid Services
Who is CMS?
“Center for Medicare and Medicaid Services” (CMS) formerly the State’s Health Care Financing is a federal agency found in the department of health and human services. The institution is responsible for providing medical care programs to over a million citizens spread across the country. Additionally, the entity works in collaboration with other health organizations to offer health coverage and children’s Health Insurance Programs (CHIP) to the public (About CMS – Centers for Medicare & Medicaid Services, 2018). CMS oversees other healthcare activities such as those that entail medical information technology, quality standards in long-term care facilities, and the health certification process primarily to enhance and modernize the health care system.
Purpose of CMS
Based on the increasing level of disease occurrence among the elderly aged above sixty-five years and lack of proper medication for the populace, the government created the CMS primarily to provide health coverage to the aged. Additionally, the program covers other qualified groups of individuals such as the physically challenged in a bid to improve the nation’s health care system. The agency formulates, interprets, and institutes the health quality and safety criteria and analyzes their effects on the operation and cost of Medicare (About CMS – Centers for Medicare & Medicaid Services, 2018). Equally, the institution evaluates the situation and authenticates the certification process for manufacturers of health products. The syndicate regulates information and data provision, acquisition, and system necessity for the Professional Standard Review Organization (PSRO) and offers certification programs.
Importance of CMS to Health Care Organizations
The development of the CMS led to a significant benefit to the healthcare organization since the agency aids in the creation of policies that affects the medical settings. The implementation of the Hospital-Acquired Conditions Present on Admission (HAC-POA) payment rule by the body greatly influenced the medical stakeholders. Some of the benefits of HAC-POA include: enhanced patient-doctor relationship, teamwork, and client’ safety which is now key in each health facility across the country (Sorensen, Jarrett, Tant, Bernard & McCall, 2014). Equally, CMS has played a role in promoting effective communication in the health sector since it facilitates compliance with the electronic health information system (EHR) to store patient’s information.
Introduction of HAC-POA by the CMS substantially improved time, personnel, and sustainable utilization of materials like the need to employ health documentation expert. Transformation in the hiring process across the health entities in the country involved the increased employment of documentation specialists to help in facilitating accurate coding of client’s data (Sorensen, Jarrett, Tant, Bernard & McCall, 2014). Considerably, the creation of medication frameworks promotes conformity to the evidence-based guidelines, current protocols for prophylactic medication, and an enhanced focus on disease prevention strategies.
CMS Impact on Quality
Medicare is a state social insurance initiative targeting primarily the aged and physically challenged individuals. Enacted in 1966 the program offers health coverage benefits to over 55 million citizens thereby plays a role in enhancing the quality of medication in the country (Li & Doshi, 2016). The coverage deters disparity in the acquisition of health services since one must choose the type of health facility to obtain medication. The agency helps in enhancing higher finances in the health sector primarily to facilitate the provision of quality medication to the patients. CMS agitate for increased staffing in the hospitals and use of the evidence-based approach to offer treatments and to prevent the occurrence of diseases in the health care settings (Sorensen, Jarrett, Tant, Bernard & McCall, 2014). Hospitals are required to integrate EHR systems into their management model to assist in protecting client’s records and facilitating improved care.
About CMS – Centers for Medicare & Medicaid Services. (2018). Retrieved from https://www.cms.gov/About-CMS/About-CMS.html
Li, P., & Doshi, J. A. (2016). Impact of medicare advantage prescription drug plan star ratings on enrollment before and after implementation of quality-related bonus payments in 2012. PloS one, 11(5), e0154357. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0154357
Sorensen, A., Jarrett, N., Tant, E., Bernard, S., & McCall, N. (2014). HAC-POA policy effects on hospitals, other payers, and patients. Medicare & medicaid research review, 4(3). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4205042/