Describe a Recent Change To CMS Regulatory Reporting Requirements and The Role of a Health Information Management (HIM) Professional in Ensuring an Organization is in Compliance Essay

Describe a Recent Change To CMS Regulatory Reporting Requirements and The Role of a Health Information Management (HIM) Professional in Ensuring an Organization is in Compliance

Describe a Recent Change To CMS Regulatory Reporting Requirements and The Role of a Health Information Management (HIM) Professional in Ensuring an Organization is in Compliance

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The health care IT industry faces new challenges based on new health care insurance provider requirements, including evolving guidance from the Center for Medicare and Medicaid Services (CMS). Describe a recent change to CMS regulatory reporting requirements and the role of a health information management (HIM) professional in ensuring an organization is in compliance
Changes to CMS Regulatory Reporting Requirements and the Role of HIM Professional in Organizational Compliance
Healthcare system is marred with constant changes in rules and regulations. Similarly, the Center for Medicare and Medicaid Services (CMS) often change its rules and regulatory reporting requirements to ensure that patients under Medicare and Medicaid services are given the best and quality health care services possible.

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Describe a Recent Change To CMS Regulatory Reporting Requirements and The Role of a Health Information Management (HIM) Professional in Ensuring an Organization is in Compliance

 

The recent change to CMS regulatory reporting occurred in the Fiscal Year (FY) 2020 Medicare Hospital Inpatient Prospective Payment Systems (IPPS) for Acute Care Hospitals and the Long-term Care Hospital (LTCH) Prospective Payment System Final Rule. Here, CMS initiated changes to the Promoting Interoperability Programs for Medicare eligible hospitals, dual-eligible hospitals attesting to CMS, and Critical Access Hospitals (CAHs) (CMS, 2020). The Final Rule approved policies to help in continued promotion of the use of certified electronic health record technology (CEHRT), lowering the burden, and enhance patient access and interoperability of health information. CMS requires the qualified settings and CAHs to effectively implement the CEHRT meaningful use to avoid their Medicare payments reduction (CMS, 2020).
It is imperative for every facility to assign a professional to receive the organization’s hospice quality information and ensure compliance with CMS regulations. As such, the organization can task the chief information officers (CIO) with the completion of this responsibility. The CIO has a role of managing the IT departments and also acts as the administrator who can successfully steer the organization in its bid to implement IT to enhance its strategic programs. Essentially, the CIO is tasked with taking charge of all operations of health IT. As such, it is the CIO’s role to ensure that all the facility’s health information is reported to the CMS (Abdolkhani et al., 2019).
References
Abdolkhani, R., Gray, K., Borda, A., & DeSouza, R. (2019). Patient-generated health data management and quality challenges in remote patient monitoring. JAMIA open, 2(4), 471-478. https://doi.org/10.1093/jamiaopen/ooz036
CMS. (2020). 2019 Program Requirements Medicare. Retrieved from https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/2019ProgramRequirementsMedicare

In 1928, the Association of Record Librarians of North America was organized under the sponsorship of the American College of Surgeons (ACS) to elevate the standards of clinical records in hospitals, dispensaries, and other distinctly medical institutions.1 The ACS Manual of Hospital Standards provided direction as to what must be documented in patient records, how records should be maintained, and how to use record information to evaluate whether practices are in accordance with present-day scientific medicine.2 To enable record librarians to effectively assist healthcare organizations in meeting these standards, educational programs for librarians included training in quality-related activities. This is evidenced by June Winton’s description of one of her practicum assignments at St. Mary’s Hospital in 1936, during her senior year in the record librarian program at the College of St. Scholastica in Duluth, Minnesota:

Each student makes a group study of twenty-five cases under the direction of a member of the staff. Once the subject has been chosen and the doctor’s outline made, cases of the type desired are traced through the proper indices. After finding the charts in the filing room, we then assist in analyzing the cases for desired statistics and facts. When necessary to analysis, follow-up letters are sent to patients to ascertain post-hospital progress. Finally, the paper is assembled into useful form and typed. Our course in statistics proves as valuable in compiling these group studies as it is in making up daily, monthly and annual statistical reports.3

During her practicum, Winton learned how to collaborate with other professionals to formulate a study question and define study criteria. She used the criteria to gather information from records and directly from patients. She applied knowledge gained in her statistical course to prepare a report of the study findings. Although healthcare delivery has changed enormously since 1936, the skills Winton learned during her record librarian courses are comparable to tasks HIM professionals are doing today to support quality activities. The fundamental skills of data capture and reporting are still vitally important core HIM competencies. What has changed is the need for HIM professionals to be able to interpret and analyze performance results and effectively use information to improve healthcare quality. Driving this change is the accelerating scope and size of the quality movement.

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Describe a Recent Change To CMS Regulatory Reporting Requirements and The Role of a Health Information Management (HIM) Professional in Ensuring an Organization is in Compliance Essay

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