Management Principle's for Health Professionals

Management Principle's for Health Professionals

The Effects of HIPAA

The passage of HIPAA's Administrative simplification Rule has been instrumental with advancing electronic data interchange as it provides a paperless work process .83% of claims were submitted electronically in the previous years. Transactions are electronic claims involving the delivery of information from one party to another for specific purposes. HIPAA mandated the implementation of health care system for administrative transactions, such as claims, eligibility, remittance and other requests and responses. Majority of Medicare Part A and Part B claims transactions are delivered electronically. HIPAA has mandated that the health industry must follow the standard formats for electronic transactions. The ASCA act of 2001 mandated electronic claims usage after October 16, 2003. In January 16, 2009, HIPAA announced to adopt coding system of CD-10-CM and ICDt-10, which replaced the old 4010 versions with Version 5010. Many are modifying their outdated systems to adopt the new system (Cms.gov )It has affected the health care systems by the following way:

It ensures the quality, efficacy and safety of care. It reduces the requirment for attachments for details of patient's condition.It improves payment systems and processing of claims.It improves health policy.It helps in conducting research, clinical trials and epidemiological studies.It modifies health care delivery systems, and monitors proper utilization of resources.It prevents and detects fraud and abuse. It tracks public health care related risk.

Example

The example of this system is McLaren Health Care Corporation, which has implemented the HIPPA system in their organization.

A Health Care Organization

McLaren Health Care Corporation is a healthcare delivery system that is associated with health plans and has more than 200 doctors, and maintains hospitals in seven markets in Michigan (Mclaren.org).

Goals

Strengths

The goals of organization are to improve the effectiveness and quality of health services for all Americans and increases access to health benefits. They aim to create products to make health care delivery easier and affordable (Mclaren.org).

Weaknesses

The economy of Michigan is weak and its hospitals operate in markets that are prone to the auto industry struggling (Mclaren.org).

Objectives and Vision

Strengths

The service rates and product rates are continuously increasing, although there are lot of things that influence the rates such as aging population, increase in disease states, etc. They should focus on slowing this cost growth rate to avoid putting pressure on consumers (Mclaren.org).

Weaknesses

Company is facing issues regarding resource allocation to manage their large chain of hospital in all places. Since the past five years, there rate of new plans implementation is very low (Mclaren.org).

Mission

Strengths

The mission of organization is to make people know about the services they are providing. They look the market differently. By making others know like employers, consumers, and providers can help in making progress (Mclaren.org).

Weaknesses

McLaren medical centers have to face lot of competitive in health care markets. McLaren markets are very competitive, because of presence of two hospitals in the every metropolitan healthcare market. However, it has earned 30.8% market share in 2010. Its closest competitor, Sparrow Health System, earned ...