Reimbursement Abjuration on Centres for Medicare and Medicaid Services (CMS)

Class & Professor,

The reimbursement abjuration on Centres for Medicare and Medicaid Services (CMS) healthcare system targeted conditions that rose on the patients during their hospital duration period. CMS needed the conditions present during admission pointers on secondary admission diagnosis and further illegalized the hospitals on billing payee for variances among the high and lower payment charges. The proposed after deductions consequence of the change is for claims to be paid without the inclusion of secondary diagnosis hence transmitting financial role to hospitals. The objective of the policy is to reducing cost whereas the preclusion of adverse happenings is encouraged. The monetary incentive for quality through CMS has resulted in modest progress in quality care methods (Hebda, Hunter, & Czar 34).
Implications of the standardized language have resulted in nursing education, administration, and research (Hebda, Hunter, & Czar 38). Nurse educators can utilize the inherent knowledge of the standardized nursing language in educating upcoming nurses, for instance, a system can be utilized in the description of the exceptional responsibility of nurses. Also, nurse educators can encourage learners to apply terminologies such as NIC (Nursing Intervention Classification) or NOC (Nursing Outcome Classification) in instances of acute care. Secondly, standardized languages are essential in initiating research on standardized languages such as NIC and NOC using an electronic database for research. Thirdly, computer records on standardization language enable investigators and quality upgrading staff to utilize actual data which is more freely available and retrievable compared to the past which was time-consuming to acquire information.
Evidence-based practice guidelines influence patient outcomes and compel improved practice care through the translation of research into practices with numerous strategies in place. Additionally, what may work in a circumstance of care may not necessarily work in another situation hence the importance of proposing different context in implementing the evidence-based practices (Tastan, et al, 1165).

Works Cited
Hebda, T., Hunter, K., & Czar, P. (2019). Handbook of informatics for nurses & healthcare professionals (6st ed.). New York, NY, Pearson.
Healthcare Information and Management Systems Society. (2013). What is interoperability? http://www.himss.org/library/interoperability-standards/what-is- interoperability (Links to an external site.)Links to an external site.
Tastan, et al, (2014). Evidence for the existing American Nurses Association-recognized standardized nursing terminologies: A systematic review. International Journal of Nursing Studies, 51(8), 1,160–1,170. doi:10.1016/j.ijnurstu.2013.12.004. Retrieved from https://chamberlainuniversity.idm.oclc.org/login?u… om/login.aspx?direct=true&db=ccm&AN=103959650&site=eds- live&scope=site (Links to an external site.)Links to an external site. (Links to an external site.)Links to an external site.

  • Lacey Prien


    Manage Discussion Entry

    Olubukola,I think you did a great job explaining the impact of Medicare and Medicaid services on healthcare systems. I really agree with reducing healthcare costs, as you mentioned this is the objective, but I also think there are certain things that patient’s need done in order to monitor them effectively and Medicare or Medicaid won’t cover this. For example, in our clinic Medicare will not permit an A1C to be checked more than every three months otherwise the patient has to sign a waiver and pay out of pocket for this test. The problem with this is, if a provider makes an adjustment to diabetic medications and the patient is having adverse reactions such as dizziness, confusion, and weakness, the provider needs to recheck the A1C to see if it may have dropped too quickly in to short of an amount of time. Overall, I enjoyed reading your post and thank you for sharing. Lacey

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