Regulatory Agencies and Accrediting Bodies

This assignment is designed to give you a greater understanding of regulatory agencies and accreditation bodies, including their functions, public reporting requirements, and the how they impact quality and safety.

Select and evaluate a regulatory agency or accrediting body.

  • Discuss the history of the agency or body.
  • Explain the reason for its existence.
  • Summarize the agency’s public reporting of quality indicators:
    • Frequency
    • Where they are reported
    • Why public reporting of these metrics is important
  • Explain how the agency or body operates:
  • Analyze the impact the agency or body has on quality at each level of health care:

Cite-Reference in an APA-formatted reference page.

Format your assignment as one of the following:

  • 18- to 20-slide presentation. The title and reference slides do not count. Include at least 400 words throughtout your speaker notes. Must cite all spaker notes using APA format. Must format references using APA format to include double spacing and hang indent. Use citation generator.

Or

  • 875-word APA 6th edtion format paper (May use APA Template). Must cite and reference your work. Use level headings to clearly identify each required assignment section on your paper.

Expert Solution Preview

Introduction:
Regulatory agencies and accrediting bodies play a crucial role in ensuring the quality and safety of healthcare services. These organizations are responsible for setting standards, monitoring compliance, and providing public reporting on quality indicators. In this assignment, we will discuss the history, functions, and impact of a regulatory agency or accrediting body on the healthcare system.

Question: Select and evaluate a regulatory agency or accrediting body.

Answer: The regulatory agency selected for evaluation in this assignment is the Centers for Medicare & Medicaid Services (CMS). CMS is a federal agency within the United States Department of Health and Human Services responsible for overseeing the administration of Medicare and Medicaid programs, along with the implementation of quality improvement programs in healthcare facilities.

Question: Discuss the history of the agency or body and explain the reason for its existence.

Answer: CMS was created in 1965 under the Social Security Act Amendments, which established Medicare and Medicaid programs. The main purpose of CMS is to ensure access to quality healthcare services for individuals who are eligible for Medicare or Medicaid. CMS is also responsible for developing, testing, and implementing innovative payment and service delivery models to improve health outcomes and reduce costs.

Question: Summarize the agency’s public reporting of quality indicators: Frequency, Where they are reported, Why public reporting of these metrics is important.

Answer: CMS publicly reports quality indicators on a regular basis through its website, Hospital Compare, and Nursing Home Compare. These reports are updated every year to reflect the most recent data available. Public reporting of quality indicators is important because it provides transparency and accountability to healthcare providers. It also allows patients to make informed decisions about their healthcare and provides a platform for continuous quality improvement.

Question: Explain how the agency or body operates: Current function, Organizational structure, Governance.

Answer: CMS operates through a network of regional offices, which oversee state Medicaid programs and implement Medicare programs. The agency’s current functions include administering and enforcing Medicare and Medicaid programs, implementing quality improvement initiatives, and promoting healthcare innovation. CMS is organized into various centers, including the Center for Medicare, Center for Medicaid and CHIP Services, Center for Clinical Standards and Quality, and Center for Medicare and Medicaid Innovation. The agency is governed by an appointed Administrator who reports to the Secretary of Health and Human Services.

Question: Analyze the impact the agency or body has on quality at each level of health care: Health care organizations, Nursing practice, Patient care.

Answer: CMS has a significant impact on healthcare quality at various levels, including healthcare organizations, nursing practice, and patient care. At the organizational level, CMS sets standards for facility accreditation, licensing, and reimbursement. Nursing practice is affected by CMS through regulations related to staffing ratios, training requirements, and scope of practice. At the patient care level, CMS promotes quality improvement and patient safety through the implementation of evidence-based practices and public reporting of quality indicators.

Conclusion:
In conclusion, regulatory agencies and accrediting bodies play a vital role in ensuring the quality and safety of healthcare services. CMS is one of the most important regulatory agencies in the United States that oversees the administration of Medicare and Medicaid programs and implements quality improvement initiatives. Through its public reporting of quality indicators, CMS provides transparency and accountability to the healthcare system. Its impact can be felt at every level of healthcare, from organizational management to nursing practice and patient care.

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