WHY HEALTHCARE REGULATION IS COMPLEX THE INTRICACIES OF THE REGULATORY PROCESS
Healthcare regulation is a multifaceted process. It involves government agencies on the federal, state and local levels, as well as hundreds of private organizations. These organizations include the Joint Commission and medical specialty boards. Definition of Joint Commission: Works to improve healthcare for the public in collaboration with other stakeholders by evaluating healthcare organizations and inspiring them to excel in providing safe and effective care of the highest quality and value. www.jointcommission.org The collaboration of these government agencies and private organizations is critical to the successful implementation of the laws they are charged with executing. Healthcare regulation is structured purposefully with this balance of public and private partnerships in an effort to ensure that each facet in the process has a represented voice. Here are just a few examples of why healthcare regulation is so complex: Patients are insured through Medicare, Medicaid, an employer’s insurance plan, or through the ACA marketplace. Insurance premiums and medical expenses may be paid for by the federal government, a state government, an employer, or by individual patients, themselves. Healthcare providers within each plan are paid differently, and the codes by which healthcare providers bill for services are different. Some hospitals and organizations are not-for profit, for-profit and some are run by the federal government (e.g., the Veterans Administration).
Despite all these many moving parts, the one constant is the patient. Healthcare agencies, both public and private, are focused on providing the utmost quality of care to patients in need. The system is set up to hear from all interested stakeholders, and advocates are stakeholders too, so allow your voice to be part of the regulatory process.
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