The Lawmakers Introduced the Stark Law (Coursework Sample)
This assessment is 2 parts. Create a 3-4 page executive summary of tools and best practices for quality improvement, risk management, and learning guidelines. Include a summary table that describes the status of an organization's compliance with regulatory requirements.
The scope of the regulatory environment and its requirements are ever-changing. Health care leaders need to know where they can find information about the requirements (within the subsector of the industry) to respond appropriately to issues. In addition, health care leaders need to proactively set strategies in place to mitigate future risks to their patients and organizations.
It is an exciting time in health care as all of us experience the implementation of the Patient Protection and Affordable Care Act of 2010. The change will likely affect your current or future health care job. Leaders in our industry are rethinking how business is to be conducted.
Understanding relevant terminology is an important step in addressing the topics of health care quality, risk management, and regulatory environment.
Step One: Executive Summary Table
Select a risk-management issue within a specific health care setting or organization. You will use this issue as a starting point for your work on this assessment. Use the Executive Summary Table linked above to complete this step.
Issue: Write a brief description of the risk-management issue you selected. Explain why this risk-management issue is important to your organization
Step Two: Executive Summary
Using the information assembled in Step One, prepare a 3–4-page executive summary for a written presentation to the management team. Select a format for your summary based on your chosen organization's standards for executive summaries. (Examples of these types of documents can also be found using an Internet search.) Include the following:
• A proactive assessment of your organization's compliance with the regulatory requirement to promptly identify POAs and proactively assess and manage risk based on existing regulations and requirements.
• Your identification of tools and best practices for monitoring parameters and reducing risk, including organizational structure needed for risk reeducation, as supported by the literature.
• Your recommendations for quality improvement and organization-specific risk management and learning guidelines.
• You must include the completed table from Step One as an appendix to this executive summary.
The Lawmakers Introduced the Stark Law
HACs often arise as a result of a physician making a deliberate choice to subject the patient to a controllable condition so that they can refer the patient to another healthcare institution where they will have a financial benefit. Unfortunately, such a practice is driven by the desire to live within the expectations of the kind of lifestyle expected of the healthcare providers (Swiderski et al., 2021). Society happens to regard healthcare providers in high esteem such that they would desire to meet such expectations (Swiderski et al., 2021). Unfortunately, healthcare providers have been disregarded in the past because they would want to generate extra income other than the money they earn from the leading practice in their workplace (Cain et al., 2020). In such an instance, loyalty is divided between providing the required healthcare and meeting their personal needs.
The challenge with this kind of scenario is that healthcare providers tend to prioritize their personal needs rather than the need to protect the lives of their patients. It is more related to commercializing healthcare and completely disregarding their immediate employer (Swiderski et al., 2021). That is why we find patients becoming subjects to HACs, and subsequently getting referred to other hospitals where the referring doctor will gain financially (Cain et al., 2020). While this is an unethical practice in healthcare, it is essential to note that it is driven not only by the healthcare providers' desire to generate more income but also by the fact that we need to ensure that they are well remunerated to sustain the expectations that the society has on them.
Having observed such challenges, the lawmakers introduced the Stark Law in 1989 to help regulate physicians' practice. Named after Rep. Pete Stark, this law aimed to curb physician self-referral. Initially, the law sought to ban physicians from making patient referrals to certain hospitals where the patient would receive treatment under the federal government's Medicare or payment by any other government (Kanter & Pauly, 2019). Self-referral refers to a situation where a physician refers a patient to a designated hospital or a healthcare institution where the physician or an immediate family member will gain financial benefits from the referral (Cain et al., 2020). The law was geared toward barring the financial motivation in healthcare provision from referring patients to other healthcare institutions, whether through HACs guided by the healthcare provider or malicious activities.
In our healthcare institution, we realize the need to ensure that every patient who visits the institution is not subjected to HACs, for the individual benefit of the healthcare provider. All healthcare providers must ensure that every patient is provided with the most appropriate type of care that does not rely on having to refer the patient to another healthcare institution (Swiderski et al., 2021). However, considering the nature of humanity, we all seek to have our lives better, which means that we need to find a way to make a way that ensures that our physicians do not violate this rule. In other words, it means that we should find ways of making it possible for patients to acquire the best form of medication without having opportunities for physicians to monetize the process of healthcare acquisition.
To make this possible, our institution has ensured that all medical practitioners hired are well remunerated to avoid the possibility of them being enticed by other healthcare institutions for additional income. Such an endeavor is the only way to ensure that patient health and care are maintained high (Kanter & Pauly, 2019). We have observed that most physicians who violate the Stark law are driven by the desire to lead a life that matches their profession. It means they desire sufficient income that allows them to lead a lifestyle society requires them to live. Society tends to be brutal when it comes to expectations (Swiderski et al., 2021). Medical practitioners are the most highly rated persons in the world, meaning they have to be sufficiently remunerated to avoid instances where the institution falls prey to violations of the Stark law.
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