HC 405 Gateway Community College Healthcare Quality Article Review

Description

review an article or case study, published within the last five years, on tilization management¦nbsp;The topic should align with quality or performance improvement.

Utolization management is a key function of managed care, and the process not only helps reduce unneeded procedures or treatments but also reduces costs. There are a few terms that one needs to be familiar with as they relate to utilization management. MACRA, or the Medicare Access and CHIP Reauthorization Act, was passed in 2015 and changes how Medicare pays physicians based on value instead of volume. MACRA led to the decline of fee for service (FFS) reimbursement where providers were paid based on each service regardless. This led to a new payment system called Merit-Based Incentive Payment System (MIPS) which uses performance scores to identify providers who may receive a bonus payment, be penalized with the provider owing a payment, or no payment adjustment. Alternative payment models (APM) also arose from the MACRA passage which can include models like accountable care organizations and others.

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Article Review: Template [Add title of article reviewed here]
First Name Last Name
Herzing University
HC 405 ealthcare Quality
InstructoràName
Due Date for Assignment
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Article Review: Template [Add title of article reviewed here]
1. Article title
Add your text here.
2. Background (summarize the article/study in a few sentences. Do not copy and paste abstract).
Add your text here.
3. How is the article topic relative to quality improvement? Elaborate on Question #2.
Add your text here.
4. What is the aim statement?
Add your text here. Include appropriate citation.
a. Detail how the aim statement qualifies as SMART
Add your text here.
5. Who are the stakeholders identified in the article?
Add your text here.
6. If applicable, summarize how the PDSA cycle was used.
Add your text here.
7. How is data collected and analyzed?
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8. Is a baseline clearly established? This could be a baseline of data, performance, etc.
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9. What are the limitations of this study? How can they be reduced for further research?
Add your text here.
10. Provide additional thoughts or ideas, if any, relevant to your professional application of this
research.
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References
Author Last Name, First Initial. (year of publication). Title of the article. Name of the
periodical, volume (issue), page range start-page range end. DOI web address

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