HI215: Reinbursement Methodologies Topic #1: The Patient Protection and Affordable Care Act The Patient Protection and Affordable Care Act ensured that all Americans have access to quality health care

HI215: Reinbursement Methodologies

Topic #1: The Patient Protection and Affordable Care Act

The Patient Protection and Affordable Care Act ensured that all Americans have access to quality health care. The Affordable Care Act contains the following 10 titles:

Title I. Quality, Affordable Health Care for All Americans

Title II. The Role of Public Programs

Title III. Improving the Quality and Efficiency of Health Care

Title IV. Prevention of Chronic Disease and Improving Public Health

Title V. Health Care Workforce

Title VI. Transparency and Program Integrity

Title VII. Improving Access to Innovative Medical Therapies

Title VIII. Community Living Assistance Services and Supports Act

Title IX. Revenue Provisions

Title X. Reauthorization of the Indian Health Care Improvement Act

Instructions:

• Select and research 3 of the 10 titles of the Affordable Care Act; describe and explain your 3 selected titles.
• Analyze the 10 titles and discuss how they impact the health care systems and reimbursement.

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• HI230: Quality Assurance and Statistics in Health Information
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• Topic #2: Roles
• To ensure appropriate resource coordination, what roles should be performed by case management or utilization review staff? How do these roles allow for better communication with different departments? Share your perspective and justify your position.

Criteria Level III Level II Level I Not Present Criteria 1 Level III Max Points: 4 points Level II Max Points: 3.2 points Level I Max Points: 2.4 points Not Present 0 points Criteria 1: Initial Post Content Quality ? Responds to all parts of the topic(s) with supporting details. ? Responds to all parts of the topic(s). Any of the following are true: No initial post to the topic(s). ? Post includes original thoughts, opinions, or ideas. ? Post includes support from multiple outside sources and/or course materials if required. Criteria 2 Criteria 2: Responses to Others and Engagement in Social Learning ? Post includes original thoughts, opinions, or ideas. ? Post includes support from one outside source and/or course materials if required. ? Does not respond to all parts of the topic(s). ? Post shows no originality when compared to other responses. ? Post does not include outside sources and/or course materials if required. Level III Max Points: 3 points Level II Max Points: 2.4 points Level I Max Points: 1.8 points Not Present 0 points ? Posts two or more responses to others. ? Posts two or more responses to others. Any of the following are true: No responses or ? Does not post at least two responses to others. responses do not follow professionalism and netiquette. ? Two or more responses to others ask follow-up questions or provide additional ideas that expand ? One response to others ask follow-up questions or provide additional ideas that expand on the topic. ? Responses to others do not ask follow-up questions or provide additional ideas Criteria Level III Level II on the topic. Criteria 3 Criteria 3: Post timeliness and length *(applies to DBs with posted length requirements) Level I Not Present that expand on the topic. Level III Max Points: 1.5 points Level II Max Points: 1.2 points Level I Max Points: 0.9 points Not Present 0 points ? Provides an initial post by 11:59 p.m ET on Sunday. ? Provides an initial post by 11:59 p.m ET on Sunday. Any of the following are true: No posts. ? All posts and responses to others meet length requirements (or no length requirement stated). Any of the following are true: ? Provides an initial post after Sunday. ? Initial post does not meet the length requirement. ? None of the posts meet length requirements. ? Responses do not meet length requirements. Criteria 4 Criteria 4: Spelling / Grammar / Formatting / Mechanics Level III Max Points: 1.5 points Level II Max Points: 1.2 points Level I Max Points: 0.9 points Not Present 0 points ? Displays college-level writing in Standard English free of spelling, grammar, or punctuation errors. Any of the following are true: Any of the following are true: No posts. ? Displays college-level writing in Standard English with few spelling, grammar, or punctuation errors. ? Writing includes frequent spelling, grammar, and/or punctuation errors. ? Includes citations when additional sources are used, including title, author, ? Citations are included when additional sources are ? Citations are included when additional sources are used but only include one or Criteria Level III Level II Level I Not Present publication date, and access type (URL, text information, etc). used, but any of the following may be incomplete: title, author, publication date, and access type (URL, text information, etc). two of the following elements: title, author, publication date, and access type (URL, text information, etc). Maximum Total Points 10 8 6 0 Minimum Total Points 8.1 6.1 0.1 0