The Role of Governmental Regulatory Agency and its Effect on the Health Care Industry

Government agencies do have a role in the governance of the healthcare industry with the aim of protecting members of the public. This paper examines two government agencies that regulate and protect the public health at every level. These agencies are the Department of Health and Human Services (HHS) and Center for Disease Control (CDC). This paper presents a brief discussion of the structure of these agencies and   looks at their role and impact to the health organization in detail.   The last section examines the accreditation of CDC and HHS and the impact they have to the members of the public.

Center for Disease Control (CDC)

The regulations and laws of CDC present information and guidelines on topics dealing with health promotion and disease prevention. This is done by the   CDC information sector that deals with the provision of consistent, timely, accurate, and science based information.  CDC also has the department of human services and health that has the reasonability of preventing the initiation, spread and transmission of highly communicable diseases into the country and other nations out of the United States.  Other sub agencies in CDC deal with issues of offering quarantine services to cargo and animals both within and out of the country such as South America and Africa. These efforts by CDC are with the aim of preventing viruses and diseases and promoting human health and reproduction.

Impact of CDC to healthcare

CDC impact to the health care agencies is seen through its regulations, guidelines, and laws. These laws are applicable to the local and state healthcare facilities. The health care industry always aims at achieving the expectations of the set guidelines on its content and preparedness plan. The ten Essential Public Health Services (2012) of CDC are responsible to ensuring the availability of the set national standards   in preparedness on public health system and to support their healthcare plans. At the local level, there are regulations that deal with planning processes and implementation of strategic plans that examine areas of vulnerability and hazard management. The aim of the jurisdictions is to ensure that the assigned duties to the health care facilities conduct their duties together with accomplishing their after action plans. The CDC rules are connected with other external agencies such as the homeland security department. These agencies work together to serve in health protection among the citizens and foreigners to the United States.

CDC also relates with HIPAA and national public health performance standards program (NPHPSP) agencies with the aim of protecting the public’s health care. Together the agencies have developed public health standards applicable to the local and state public health systems and other agencies that govern public health (National Public Health, 2012). These agencies have the duty of providing assistance on technical issues, system planning, and analyzing reports. The CDC agency works in coordinating different regional locations to ensure state wide quality and assessment on the actual work that is implemented. Its goal in every step of its duty is to encourage and build all parties for the sake of promoting healthcare readiness and good health. It also aims at providing performance report for each healthcare facility and ensuring the constant use of these reports often.  CDC always pushes the health care industry to improve on the quality of health care services they provide to the public.

Finally, CDC always aims at improving the medical practices that are implemented at the time of preparedness.  Based on the Code of Federal Regulations (CFR), CDC through its different agencies work to coordinate and adopt the different federal regulations. There are various agencies of CDC that help CFR in healthcare facilities. This is because CFR laws and adherence to these laws mainly impact on the healthcare agencies.

The process of authorization, certification, and accreditation is done by the Centers for Disease Control and Prevention (CDC). This is done with the partnership of CDC with Robert Wood Johnson Foundation. Together, form a   national voluntary accreditation program for territorial, local and tribal health care departments. The program further assists through technical assistance and staffing in the assistance of accreditation so as to assist work groups and committees of Public Health Accreditation Board (PHAB) and solicit expertise in various areas of CDC.

Impact to the community

I have witnessed the impact of CDC activities to my local community. CDC has managed to have managed to promote a healthy community designing. I have seen the foundation of   the Safe routes to learning intuitions. This project was done by CDC in partnership with National Partnership group that was with the aim of assisting the low income school in my community.  I saw this program as one of immense help in protecting and increasing the safety of children cycling or walking to this school. These are children who come from low income background, and parents do not have enough resources to cater for private or public transport of their children. This shows the effort of CDC to assist in developing health consideration in neighborhoods.

Department of Health and Human Services (HHS)

The Department of Health and Human Services (HHS) has a wide range of regulatory bodies that aim at protecting and regulating public health in every level. HHS is a federal agency principle that provided essential services needed buy humans and ensures the health of all Americans is protected. HHS administers Medical programs. It also governs other three hundred programs through its eleven operating divisions (HHS, 2011). The following are two current healthcare regulations passed by HHS that have an impact on healthcare organizations

Readmissions Regulation and Patient Protection and Affordable Care Act (PPACA)

The current healthcare cost of the United States has gone beyond control. The cost of healthcare is three times higher compared v to other developed nations of the world. This is attributed to the complex and fragmented structure of United States healthcare system (Kaiser Family Foundation, 2011). The Medicare Payment Advisory Commission in 2005 reported hospital readmission formed a total of 17.6%. These admissions happen within a short period of 30 days (Hoffman & Stone, 2010).

Evidence further shows that there is variation of readmission rates depending on one’s geographic location or hospital, and this suggested that some hospital made use of readmission rates to make profits (Hoffman & Stone, 2010).  President Obama in March 2010 passed the Patient Protection and Affordable Care Act. It provides the necessary provisions for Medicare changes. The intention of the provision is to reduce on the rate of hospital readmission especially for those cases that are preventable. The aim of president Obama in signing the PPACA into law was to reduce the rising costs of healthcare in US healthcare system. This is through the prevention of services that are unnecessary or readmission charges that can be prevented.

Patient Protection and Affordable Care Act will see that those hospitals with high rates of admission are reduced. The law is also concerned with measuring, and evaluating the care that a patient receives in his or her stay period in hospital. The laws also apply after discharged   from hospital. These are patients with chronic illnesses who need follow-up services at post-charge.

Health Insurance Portability and Accountability Act (HIPAA)

The Health Insurance Portability and Accountability Act (HIPAA) were passed by the Congress in 1997 to provide privacy and protection to the health care information of patients. The information provided by patients concerning their health has to be regarded as private and confidential. All healthcare facilities should use a healthcare facility that ensures that no third party gains access to patient’s private information. This means that the healthcare organizations have the responsibility of protecting electronic data forms as well as the written PHI. This law came at a time when the electronic age allowed research institutions and healthcare organizations can use and retain large data on patient information for their own analysis. The use of modern day technology has provided a better way to understand vast complex data in a simpler way. This understanding has helped in the development of new and better methods of treatment   for various complex and chronic diseases.

However, despite this positive impact of technology to the medial filed, there is also high risk of data misuse (Harris, 2008).  This opportunity to misuse personal data of personal data has a negative impact to the wellbeing of patients. It is, therefore, essential to ensure that the information of patients is held private because any sensitive information of the patients has to gain warrant in distribution and use. The Institutional Review Boards (IRBs) is responsible in ensuring that the confidentiality and privacy of patient information is according to the procedures and policy requirement provided by the HIPAA guidelines (O’Herrin, Fost, & Kudsk, 2004).

Failure to adhere by the guidelines poses substantial penalties to healthcare organizations. Following strict regulations ensures that the health care organization is capable of delivering patients with timely healthcare services. Patients have to first sign a consent form before release and sharing of their private health information. Healthcare organizations have to invest in various ways that will help them strengthen their information structure so as to ensure that patient’s information is kept safe.

Effect of PPACA and HIPAA Laws to community

The provisions of PPACA aim at reducing healthcare payments to health care intuitions mainly on the rate of readmission. With the implementation of this law, my community hospital has shifted its budget from reliance on encourage companies to cater for readmission fees into taking responsibility of implementing prevention programs for chronic diseases. These programs will benefit the members of the community to maintaining healthy living in order to minimize the risk of chronic diseases that are expensive to treat (Jencks, Williams, & Coleman, 2009).

The Health Insurance Portability and Accountability Act have also helped in promoting the safety and confidentiality of patient’s information. Since the passing of this law, I have never heard of cases of misuse of patient’s information in the local community health center I work. I am also more confident in providing private details to my physician because I know that for one to use my health information, it is necessary that I sign a consent form (Morrison, 2011). Therefore, I am more control of my private personal data than before.

References

Center on Budget and Policy Priorities (2006) The Number of Uninsured Americans. Retrieved from http://www.cbpp.org/files/8-29-06health.pdf

On Dec 14th 2012

Department of Health & Human Services (2011) HHS Leadership Open Government. Retrieved from http://www.hhs.gov/open/contracts/index.html

On Dec 14th 2012

Jencks, S, Williams, M (2009) Re-hospitalizations among Patients. The New England. Journal of Medicine, 360, 418-28. Retrieved from

http://www.nejm.org/doi/pdf/10.1056/NEJMsa0803563

On Dec 14th 2012

Kaiser Family Foundation (2011) Health Care Spending in the United States and Selected OECD Countries. Retrieved from http://www.kff.org/insurance/snapshot/OECD042111.cf

On 14th Dec 2012

O’Herrin, J. Fost, N & Kudsk, K (2004) Health Insurance Portability and Accountability Act Regulations Effect on Medical Research. Annals of Surgery, 239(6), 772-778.

Morrison, E (2011) Ethics in health administration: A practical approach for decision makers. Sudbury, MA: Jones and Bartlett

Harris, D (2008) Contemporary issue in healthcare law and ethics. Chicago: Health Administration Press.