Regulatory bodies for Health Systems
The healthcare sector is one of the most dynamic and delicate business environments that is driven by expanding population, increasing the need for quality services, and a growing burden of severe medical conditions that require special attention. Therefore, there is a need for regulatory bodies to offer frameworks that will guide the practice of medical care. In the United States (U.S.), the constitution divides the power of regulation to the federal and state governments. Also, it provides a significant role to the private regulators in overseeing physician practice and operations of the hospitals (Field, 2017). One of the federal healthcare regulators is the Center for Medicare and Medicaid Services (CMS). The organization regulates the reimbursement for healthcare products and services for Medicare and Medicaid. Also, the organization has innovative programs that develop and implements payment and service delivery models to reduce expenses and increase the quality of healthcare to its beneficiaries (Burd et al., 2017).
Another healthcare regulatory body is the Joint Commission, which falls under the category of the private regulators. The body is responsible for the accreditation of hospitals in the U.S. to ensure high-quality care as required by the CMS (Jha, 2018). Elsewhere, the Food and Drug Administration (FDA) is also a crucial regulator of the healthcare system. The body plays a leading role in the regulation of marketing and the use of medical products (Field, 2017). Before marketing a pharmaceutical product, the body oversees and advises sponsors concerning its safety and efficacy using market data. The FDA is also responsible for monitoring the safety and effectiveness of the product following its marketing. Finally, the state insurance department constitutes one of the standard health system regulators at the state level. The body is responsible for the regulation of insurance services and can offer crucial information concerning health coverage.
References
Burd, C., Brown, C., Puri, P., & Saghavi, D. (2017). A Center for Medicare & Medicaid services
lens toward value-based preventive care and population health. Public Health Reports, 132(1):6-10. https://doi.org/10.1177/0033354916681508
Field, R.I. (2017). Regulation of health care in the United States: Complexity, confrontation, and
compromise. An Inst Hig Med Trop, 16(Suppl. 3): S61-S70.
Jha, A.K. (2018). Accreditation, quality, and making hospital care better. The JAMA Forum,
320(23) 2410-2411. doi:10.1001/jama.2018.18810