Enrollment in the Medicare Program
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Table of Contents
The Objective of the Policy
The objective of the policy to see the healthcare provider/organization/center enroll for the Medicare program to serve more patients, as well as qualify for Medicare reimbursement under the Federally Qualified Health Center (FQHC) benefits program. To achieve this objective, the hospital has to design and implement efficient EHR.
The Formulation Stage
This stage will entail three processes including selecting the desired objective, identification of the target objective, and determining the pathway to attain the objective. As stated before, the objective of the policy is to implement an EHR that will see the health organization not only qualify for federal incentives but improve service delivery to its patients. After identifying the objective, the team overseeing the policy implementation will have to contract a vendor who specializes in electronic health record systems such as Epic and Cerner Corp. However, this will be after carrying out a feasibility study based on a cost-benefit analysis (CBA) to ascertain the costs involved in implementing the program, the features of the program based on the specification of the vendor’s model, and the risks and challenges involved (Chiang et al., 2013). Part of the feasibility study will include designing ways and mechanisms of meeting the challenges of the system. The model of the EHR may not be adopted if the vendor does not provide options on how to overcome its challenges including system breakdown. Although the team is hopeful that the system will work efficiently, these measures are taken just in case the system encounters technical problems. Experiences in the past have shown how hospitals adopt the EHR systems but soon abandon them because they did not carry out a research on the model’s specification and how it intends to meet the needs of the healthcare center. A good example is the Girard Medical Center. The project will involve all the relevant stakeholders through consultation including the health centers members of the board, medical information officers, the IT department, medical practitioners, healthcare informaticists, and the chief financial officer.
The Legislative Stage
The health center will have to first apply for enrollment in the Medicare program. This can be either through the Internet-based Provider Enrollment, Chain and Ownership System (PECOS) or the paper enrollment application process such as CMS-855. The Centers for Medicare & Medicaid Services provides that a health care center or organization should have staff with necessary knowledge, skills, and experience in IT to offer technical support including a minimum of three technical assistance staff from the EHR vendor, independent IT consultants, and staff from the corporate IT department. The center should also have a care management and quality measurement mechanism. The center must also receive CMS certification number (CNN) from an appropriate CMS regional office (RO) and sign a Medicare agreement to qualify for FQHC reimbursement benefits.
Implementation Stage
All the stakeholders identified in the formulation stage will be involved in the policy implementation process. They will have to exercise a high level of accountability and integrity. The financial officer will be responsible for estimating the costs involved, as well as sourcing and allocating resources to each section of the project. The chief medical officer and health informaticists will be responsible for selecting the best vendor with expertise in EHR. The board members will have to approve the financial resources requested by the financial officer towards completing the project.
Evaluation Stage
According to Rogers, adopting technology into the system demands a comprehensive evaluation based on four essential fundamentals which are compatibility, complexity, trialability, and observable performance. Thus, the evaluation stage will consider these features in to ensure that it meets the CMS specifications. To enhance access to quality care, the EHR system of the health center should be compatible with the roles of the medical practitioners. Compatible means that there is a timely delivery of quality healthcare services by reducing the workload of the nurses and other medical specialists. Complexity refers to how the system will overcome the difficulties and challenges that medical staff may face when it starts to operate. Therefore, the system should not be complex and in case there are some elements that the staff does not understand, it will be important to train them. The system should be able to be demonstrated to medical staff before its inception. In fact, its trialability may give staff members a quick start of how it works, reducing the possibilities of staff resistance. The process of the system should be observable by the medical staff.
Analysis Stage
Lack of financial resources could be the primary challenge towards implementing the HER system considering the huge costs that are usually involved in acquiring such a system. Besides, the medical staff will also have to be trained on how to use the system. Hiring independent IT consultants are also costly and without involving them, the project may develop technical challenges. However, carrying out a feasibility study will help the management to estimate the cost of the project and come up with ways to raise necessary financial resources to implement an efficient and well-functioning EHR system. The staff will as well be trained on how the system works, minimizing the risks of employee resistance to change.
Revision Stage
The case of Girard v Cerner is a true example that court battles do not help an organization to meet its short-term objectives because most of them take time before a ruling is made. Realizing this limitation, the management has to insist on accountability from all the stakeholders involved in the implementation process.