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Health care quality is the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes. [2] Quality of care plays an important role in describing the iron triangle of health care relationships between quality, cost, and accessibility of health care within a community. [3]
The Healthcare Quality Improvement Act of 1986 (HCQIA) of the United States was introduced by Congressman Ron Wyden from Oregon. ( Title 42 of the United States Code , Sections 11101 - 11152) It followed a federal antitrust suit by a surgeon against an Astoria hospital and members of its clinic in which he claimed antitrust actions were ...
Traditional state-based legal protections for such health care quality improvement activities, collectively known as peer review protections, are limited in scope: They do not exist in all States; typically they only apply to peer review in hospitals and do not cover other health care settings, and seldom enable health care systems to pool data ...
In 2015 CMS identified 254 quality measures for which providers may choose to submit data. The measures map to U.S. National Quality Standard (NQS) health care quality domains: [4] Communication and Care Coordination; Community/Population Health; Effective Clinical Care; Efficiency and Cost Reduction; Patient Safety
Federal, state, and local governments can improve population health by evaluating all proposed social and economic policies for potential health impacts. [4] Future efforts within health policy can incorporate appropriate incentives and tactical funding for community-based initiatives that target known gaps in social determinants.
Social Security Act - Title XVIII Health Insurance for The Aged and Disabled (PDF/details) as amended in the GPO Statute Compilations collection; Medicare Prescription Drug, Improvement, and Modernization Act of 2003 as enacted in the US Statutes at Large; H.R. 1 on Congress.gov; Centers for Medicare & Medicaid Services (CMS)
Value-based insurance design (also V-BID, VBID, evidence-based benefit design, or value-based benefit design) is a demand-side approach to health policy reform.V-BID generally refers to health insurers' efforts to structure enrollee cost-sharing and other health plan design elements to encourage enrollees to consume high-value clinical services – those that have the greatest potential to ...
Health policy can be defined as the "decisions, plans, and actions that are undertaken to achieve specific healthcare goals within a society". [1] According to the World Health Organization, an explicit health policy can achieve several things: it defines a vision for the future; it outlines priorities and the expected roles of different groups; and it builds consensus and informs people.