Risk Management in Healthcare

Write a 550-900 word paper that evaluates the effect of local, state, and federal health care
legislation within organizations by identifying trends.
Be sure to address the following:
1.Describe general trends in health care legislation over the past 5 years.
2.Describe a specific piece of legislation occurring within this timeframe across the United
States. Discuss how it governs a long trending health care concern. What have been the
motivating factors that have influenced this particular legislation?
3.Discuss the effects of the trending legislation on health care overall in the United States.
4.Describe how the selected legislation effects one type of health care setting (transitional
care, hospital, primary care, home care, primary care).
5.Identify changes in your selected health care setting that have occurred during this time
in order to meet the requirements or needs of this legislative trend.
6.Discuss how stakeholders (patients, underserved populations, health care providers, staff,
etc.) have been affected by the trending legislation.
Support your paper using three to five sources.

Risk Management in Healthcare
The general trends in health care Legislation
Healthcare legislations have been introduced in the United States of America over the
past five years to make health care settings more inclusive and efficient. These legislations have
had a significant impact in achieving the overall intention of nursing care which is the provision
of patient-centered care that is cost friendly and therapeutically effective. Indeed, there was a
period in the US when Academic Health Care Centers were endangered and threatened by a
continual decline in the perceived outcome and value of patient care (Hammaker & Knadig,
2017). Due to this decline, there was a lot of pressure on healthcare providers such as doctors to
deliver. The legislation ensured that there is a considerable decrease in direct payments that are
done to doctors in Academic Health Care Centers (AHCs). Therefore, this ensured that

RISK MANAGEMENT IN HEALTH CARE 2
efficiency of AHC is maintained in the highest regard hence improving the quality of nursing
care to patients. Moreover, the general trends in legislation suggest that there is a steady increase
in the funding of research in nursing care by National Health Care Institute.
A Legislation within the last five years in the US
A legislation over the last five years is the Medicare Access and CHIP Reauthorization
Act of 2015 (MACRA). This law is also called the Permanent Doc Fix. The reforms that marked
the introduction of this law is among the largest in scale in the health care system in the US. This
law was introduced to establish new modes to pay physicians and doctors who provide care to
Medicare patients. The legislation also includes new funding to providers to enable technical
assistance and includes the funding for measure testing and development (Casalino, 2017). The
motivating factors that for a long time influenced the MACRA legislation were the need to
devise new ways to reimburse physicians because of the expected transition to the pay for a
performance model that is based on the Accountable Care Organization. This is a deviation from
the fee for service model. There was also a growing need to fill the expanding funding gap.
Additionally, the need to extend the famous Children Health Insurance Program (CHIP)
The effect of trending legislation on US health care
Over the past five years, the trending legislations such as MACRA has had a positive
impact in US health care system. Indeed, US healthcare has witnessed a considerable decline in
the disparities in the health system to a great extent. For instance, the legislation has ensured that
Medicare patients are adequately taken care of by a sufficiently reimbursed advanced health care
practitioners translating into efficient and quality care (Sayeed et., 2017). The legislation has had
a positive outcome as it has ensured the growth of allied nursing practitioners and health care
professionals. It has also led to growth in the effectiveness of very useful technologies applied in

RISK MANAGEMENT IN HEALTH CARE 3
nursing care. Furthermore, the legislations have also been credited for the increased usage of
preventative nursing care to maximize health care provision. In so doing, the US health care
system has witnessed decreased abuse and excessive utilization of expensive health services. The
trending legislation has also led to the establishment of new advisory groups for the federal
government.
The impact of MACRA on primary care
Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) will impact
positively on primary care. When a merit-based incentive program is implemented for all health
care professionals who provide Medicare to patients, it will boost the building of a health care
system that is better and smart. This is because all physicians are motivated to provide quality,
efficient and patient-centered care. The MACRA legislation will focus on measures that are
aimed at quality and highly valued health care services. Therefore, improving the overall primary
care to patients. This comprehensive legislation has significantly restructured the health care
system in the US much to the benefit of patients (Hussey, Liu & White, 2017).
The Changes in the Specialty and Acute Care Hospital Settings to meet
requirements of MACRA
Since its signing in 2015, a hospital setting such as a specialty and acute care hospitals
have developed some new technological strategies to ensure that they fulfill the requirements of
this legislation. For instance, the specialty and acute care setting has changed its payment and
reimbursement model from the pay for service to the ones required by the law which is the value
modifier and the Medicare Electronic Health Records. The specialty care setting has also
changed the design of data sharing to enable their systems to fulfill new programs and necessities
for sharing of data for funding as required by the law. This setting is changed to conform to the

RISK MANAGEMENT IN HEALTH CARE 4
pay for performance model based on quality and clinical practice enhancement as the legislation
stipulates. The acute care setting has also designed the merit-based incentive system.
The effect of MACRA on health care stakeholders
All health care stakeholders have benefited from this legislation. MACRA focuses on
improving patient care outcomes through better health care services (Squitieri & Chung, 2017).
Physicians share a similar mandate, that is enhancing the results of treatment. Patient-centered
approaches lead to healthier, better, and smarter care. This ensures patient safety, population
management, care coordination and practice assessment. Underserved populations are taken care
of as there is an increased focus on their needs. Physicians have deservedly benefited from merit
founded incentive programs.

RISK MANAGEMENT IN HEALTH CARE 5

References

Casalino, L. P. (2017). The Medicare Access And CHIP Reauthorization Act And The Corporate
Transformation Of American Medicine. Health Affairs, 36(5), 865-869.
Hammaker, D. K., & Knadig, T. M. (2017). Health Care Management and the Law. Jones &
Bartlett Learning.
Hussey, P. S., Liu, J. L., & White, C. (2017). The Medicare Access And CHIP Reauthorization
Act: Effects On Medicare Payment Policy And Spending. Health Affairs, 36(4), 697-705.
Sayeed, Z., El-Othmani, M., Shaffer, W. O., & Saleh, K. J. (2017). The Medicare Access and
CHIP Reauthorization Act (MACRA) of 2015: What’s New?. Journal of the American
Academy of Orthopaedic Surgeons, 25(6), e121-e130.
Squitieri, L., & Chung, K. C. (2017). Value-Based Payment Reform and the Medicare Access
and CHIP Reauthorization Act (MACRA) of 2015: A Primer for Plastic Surgeons. Plastic
and Reconstructive Surgery.

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