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Quality Management and Accountability Interview - Essay Example

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Quality Management and Accountability Interview Medicaid Quality Improvement Model There are certain strategies that need to be adopted in order to improve the quality of Medicaid healthcare services. They include; guidance of appropriate care with evidence-based practices, implementation of standardized measures for outcomes, informed decision-making with the help of innovative technology of health information, promotion of uninterrupted quality improvement across all states and care providers, rewarding improvements by introducing pay-for-performance strategies, development of multidisciplinary approaches of care management, integration of behavioral, acute, and long-term care, and involvem…
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The fundamental pre-requisite of effective implementation of these strategies is commitment of the top management towards the improvement of quality of the Medicaid program. Commitment of top management helps in the eradication of internal issues of the healthcare organizations so that they can become examples and set good standards for others to follow. Care starts at home, and spreads outside. Quality Assurance Procedures in Medicaid Quality assurance procedures are linked with different managerial functions in the implementation of Medicaid program like administration, planning, organizing, directing, budgeting, and training.

Quality assurance procedures adopted in Medicaid related to planning include but are not limited to planning of operations, establishment of goals and priorities for the program, preparation of annual plan of quality assurance sampling, preparation of the claims plan. Quality assurance procedures of Medicaid related to organizing and directing include assignment of the statewide sample cases, and establishment of practical deadlines for the related staff. Quality assurance requires reasonable expenditures and use of resources.

Moreover, the staff is trained to customize their skills as per the changing needs of the program and they are kept updated on the latest procedures of quality assurance. Issues in Medicaid There are different kinds of issues that are affecting the quality of healthcare in the Medicaid program presently. Economic challenges are the major problem. “In meeting [the] needs, Medicaid accounts for nearly one of every five dollars of health care spending, nearly one of every two dollars spent on longterm care and over half of public mental health spending” (Kaiser Family Foundation, 2003, p. 2). In the year 2009, revenues in the US decreased by one-third, which was indeed the biggest decline in revenues in 60 years.

This caused many states to face problems in sustaining the Medicaid program without cutting services to decline the quality of health because of the financial constraints. In the year 2009, as many as 33 states in the USA implemented freezes or cuts of the Medicaid provider rate. Six more states did the same to meet the economic challenges in the year 2010. Around the mid of the year 2011, states were just at the verge of losing critical funding to sustain the Medicaid program. In addition to these direct consequences of lack of funds on the quality of Medicaid healthcare, lack of funds are also indirectly affecting the quality because of technological advancement and lack of sufficient training and inculcation of new skills in the workers so that they are able to use the latest technology.

Lack of funds brings a compromise on the training and education of the workers. Assessment of Accountability “The quality-assurance strategy of the Medicare program (the federal program providing health insurance to elderly people and some people with disabilities) has done much, but accountability for quality remains a concern” (National Academy of Scienes, 1997). The prime way to

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