Elements of Risk Management
ELEMENTS OF RISK MANAGEMENT 1
Elementsof Risk Management
Elements of Risks Management
Risk management isan important aspect of healthcare, which is important because itaddresses some of the risks and threats facing the field andhighlights the best approaches to avoid risks from occurring andmitigating the costs of a risk. Some of the notable elements of riskmanagement include claims development and submission program andquality of care. The element of claims development and submission isassociated with how a health institution should prepare and submitclaims for payment for health insurance providers and federal healthcare programs. The element of quality of care is concerned withprioritizing the quality of care offered to clients and the processand methodology applied by organization to improve the quality ofcare through evaluation, monitoring, investigation, and enforcement.These elements are included in the risk management program of thehome health care agencies (Card & Klein, 2016).
The implementationof the claims development and submission may involve analyzing therisks that are associated with claims. Organizations shouldinternally look into such factors as incorrect coding, improperbilling, incorrect claim procedures, duplicate billing, and outdatedcharge description masters. When an organization has aligned thesewith the regulatory standards, they avoid such risks as corporateintegrity agreements, penalties, and fines. In regards to quality ofcare, a health institution should develop and implement a performanceimprovement and quality assessment programs. This will be critical inthe identification of issues that affect patient safety. This elementis critical in reducing medical errors that put the patient at riskof worsening their conditions or retrogressing health. The quality ofcare element also addresses such issues as diagnosis, treatment, andprescription accuracy, practitioner qualification, quality reportingand documentation, and medical necessity (Cagliano et al., 2011).
Cagliano, A. C., Grimaldi, S., & Rafele, C. (2011). A systemicmethodology for risk management in healthcare sector. SafetyScience, 49(5), 695-708.
Card, A. J., & Klein, V. R. (2016). A new frontier in healthcarerisk management: Working to reduce avoidable patient suffering.Journal of Healthcare Risk Management, 35(3), 31-37.
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