1. Introduction to Health Information Technology and Medical Billing1
Introduction to Health Information Technology and Medical Billing

2. Learning Outcomes When you finish this chapter, you will be able to:
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When you finish this chapter, you will be able to:
1.1 Explain why the use of technology in healthcare is increasing.
1.2 Describe the functions of practice management programs.
1.3 Identify the core functions of electronic health record programs.
1.4 List the steps in the medical documentation and billing cycle that occur before a patient encounter.
1.5 List the steps in the medical documentation and billing cycle that occur during a patient encounter.

3. Learning Outcomes (continued)
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Learning Outcomes (continued)
When you finish this chapter, you will be able to:
1.6 List the steps in the medical documentation and billing cycle that occur after a patient encounter.
1.7 Discuss how the HIPAA Privacy Rule and Security Rule protect patient health information.
1.8 Explain how the Health Information Technology for Economic and Clinical Health (HITECH) Act and the Affordable Care Act (ACA) promote health information technology and explore new models of delivering healthcare.

4. Key Terms 1-4 accountable care organization (ACO) adjudication
Affordable Care Act (ACA)
audit trail
clearinghouse
coding
Current Procedural Terminology (CPT®)
diagnosis
diagnosis code
documentation
electronic data interchange (EDI)
electronic health record (EHR)
electronic medical records (EMRs)
electronic prescribing
encounter form
explanation of benefits (EOB)
HCPCS
Teaching Notes:
Possible Assignments:
1. Have students define all key terms as an assignment. Then, in class, ask each student to define one key term aloud.
Have students do an Internet search of one key term and write a short paragraph describing what they learned about that term from looking at a few websites.
Break the students into groups, divide up the key terms as evenly as possible among the groups, and have each group present their terms to the class along with the definitions and an example for each term presented.

5. Key Terms (continued) 1-5 health information exchange (HIE)
health information technology (HIT)
Health Information Technology for Economic and Clinical Health (HITECH) Act
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
HIPAA Privacy Rule
HIPAA Security Rule
International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)
International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM)
Teaching Notes:
See Teaching Notes for Slide 4.

6. Key Terms (continued) 1-6 meaningful use
medical documentation and billing cycle
National Health Information Network (NHIN)
National Provider Identifier (NPI)
patient-centered medical home (PCMH)
patient information form
personal health records (PHRs)
practice management programs (PMPs)
procedure
procedure code
protected health information (PHI)
regional extension centers (RECs)
remittance advice (RA)
revenue cycle management (RCM)
Teaching Notes:
See Teaching Notes for Slide 4.

7. 1.1 The Increasing Use of Technology in Healthcare
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Healthcare costs are rising for several reasons:
The use of new medical technologies
Procedures and treatments have increased patient survival and the cost of medical care.
The aging population
As the population ages, spending on healthcare rises.
Learning Outcome: 1.1 Explain why the use of technology in healthcare is increasing.
Pages: 3-4
Have the class give specific examples of how and/or why an aging population might raise healthcare costs.
Have members volunteer to give examples in their lives of older family members who have experienced increased medical activity or increased costs in their medical treatment.

8. 1.1 The Increasing Use of Technology in Healthcare (continued)
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Technology is being used to track patient treatments and outcomes, which leads to the development of quality standards.
Technology makes it possible for primary care providers and specialists to confer while looking at the same CT scan on a computer, even when they are miles apart.
Learning Outcome: Explain why the use of technology in healthcare is increasing.
Pages: 3-4
Have class members describe an incident at their doctor’s office where they observed the use of technology in the medical industry. Have them explain why that particular use was important for the medical office.

9. 1.1 The Increasing Use of Technology in Healthcare (continued)
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Health information technology (HIT) is technology that is used to record, store, and manage patient healthcare information.
Technology is used to perform these tasks:
clinical tasks such as recording vital signs or ordering medications,
administrative tasks such as scheduling appointments or creating insurance claims.
Learning Outcome: 1.1 Explain why the use of technology in healthcare is Increasing.
Pages: 3-4
Teaching Notes:
AHIMA (American Health Information Management Association) is one of the groups that sets standards for management of HIT:
If possible, either project the AHIMA website on a screen for students to view or have the students research a topic from the AHIMA website on their own.

10. 1.2 Functions of Practice Management Programs
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1.2 Functions of Practice Management Programs
A practice management program (PMP) is a software program that automates many of the administrative and financial tasks in a medical practice including:
Verifying insurance eligibility and benefits.
Organizing patient and payer information.
Generating and transmitting insurance claims.
Monitoring the status of claims.
Recording payments for payers.
Generating patients’ statements, posting payments, and updating accounts.
Managing collections activities.
Creating financial and productivity reports.
Learning Outcome: 1.2 Describe the functions of practice management programs.
Pages: 4-6
Teaching Notes:
Get a blank superbill from a practice in your area to show students that the most common codes are on the superbill.
Have the students explain why they believe that practice management software programs have helped the medical industry.

11. 1.2 Functions of Practice Management Programs (continued)
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Creating and Transmitting Claims
One of the most important functions of a PMP is to create and transmit healthcare claims.
The PMP collects information from various databases. A database is simply an organized collection of information about the patient, the provider, the health plan, the facility, and more.
Monitoring Claim Status
Monitoring claim status is necessary to ensure prompt payment of claims.
A PMP is used to follow up on the status of claims. An electronic message can be send to the health plan.
Learning Outcome: 1.2 Describe the functions of practice management programs.
Pages: 4-6
Teaching Notes:
Many offices now use Electronic Medical Records which merge the front office computer software with the patient treatment information. Stress that an EMR is different from a PMP. If an office has used a PMP, then goes from paper to EMR, the person supervising the change must make sure that the two programs can communicate with each other.
Medisoft is a PMP. It is actually used in physicians’ offices in the real world. Using a PMP helps save time and eliminate errors.
Large corporations usually use the same PMP throughout their system as well as tying that PMP to the computers in the hospital. This allows the physician to access information from hospital admissions.

12. 1.2 Functions of Practice Management Programs (continued)
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Receiving and Processing Payments
A PMP receives a document that lists the amount that has been paid on each claim and reasons for nonpayment or partial payment of claims.
Learning Outcome: 1.2 Describe the functions of practice management programs.
Pages: 4-6
Teaching Notes:
When PMPs are used, scheduling is easier, patient information input has less errors, claims are submitted faster, money is received faster, patient accounts are easier to track, and financial reports can quickly be pulled to justify purchases, staffing, etc.

13. 1.3 Functions of Electronic Health Record Programs
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An electronic health record (EHR) is a computerized lifelong healthcare record for an individual that incorporates data from all providers who treat the individual.
Documentation is a record of healthcare encounters between the provider and the patient.
An electronic medical record (EMR) is the computerized record of one physician’s encounter with a patient over time.
Learning Outcome: 1.3 Identify the core functions of electronic health record programs.
Pages: 6-14
Teaching Notes:
EMRs are different from PMPs. They can include information from other places where the patient has been seen, such as laboratories, hospitals, pharmacies, etc. A lot of hospitals now use hospitalists to take care of patients when they are admitted to the hospital instead of the patient’s primary physician. EMRs allow the patient’s personal physician to access the information from a hospital visit when the patient is in the office for a follow-up appointment.

14. 1.3 Functions of Electronic Health Record Programs (continued)
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Personal health records (PHRs) are private, secure, electronic files that are created, maintained, and owned by the patient.
The Institute of Medicine suggests that an EHR include:
Health information and data elements
Results management
Order management
Decision support
Electronic communication and connectivity
Patient support
Administrative support
Reporting and population health
Learning Outcome: 1.3 Identify the core functions of electronic health record programs.
Pages: 6-14
Teaching Notes:
PHRs are the information contained in the EMR. This is the information that you must have permission to release from the patient. Information comes from multiple providers and facilities.
Electronic prescribing is part of order management. It also helps save time and increase accuracy.

15. 1.3 Functions of Electronic Health Record Programs (continued)
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Health Information and Data Elements
Demographic information (address, phone numbers, patient name)
Clinical information about the patient’s past and present health concerns (problem list, signs and symptoms, diagnosis, procedures, treatment plan, medications list, allergies, diagnostic test results, radiology results, health maintenance status, and advance directives)
Learning Outcome: 1.3 Identify the core functions of an electronic health record system.
Pages: 6-14
Teaching Notes:
The following EHR functions are suggested by the Institute of Medicine:
1. Health information and data elements
2. Results management
3. Order management
4. Decision support
5. Electronic communication and connectivity
6. Patient support
7. Administrative support
8. Population reporting and management

16. 1.3 Functions of Electronic Health Record Programs (continued)
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Results Management
Computerized results can be accessed by multiple providers when and where they are needed.
Order Management
Staff members in different offices and facilities can access orders which eliminates unnecessary delays and duplicate testing.
Decision Support
An EHR gives physicians immediate access to clinical research on diagnosis, treatment, and medications.
Learning Outcome: 1.3 Identify the core functions of an electronic health record system.
Pages: 6-14
Teaching Notes:
Computerized results management allows for efficient results reporting, results notification, multiple views of data/presentation, and multimedia support (images, scanned documents).
Computerized provider order entry (CPOE) allows for electronic prescribing and access to the laboratory, pathology, x-rays, and consultations.
Decision support involves access to knowledge sources, drug alerts, reminders, clinical guidelines and pathways, guidelines for chronic disease management, clinician work lists, diagnostic decision support, epidemiologic data, and automated real-time surveillance,
Electronic prescribing – a major component of order management – involves the use of computers and handheld devices to transmit prescriptions in digital format.

17. 1.3 Functions of Electronic Health Record Programs (continued)
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Electronic Communication and Connectivity
Physicians, nurses, medical assistants, referring doctors, testing facilities, and hospitals can communicate with one another through a number of mechanisms within the EHR.
Patient Support
The EHR offers patients access to educational materials and instructions for tests, as well as the ability to report home monitoring.
Learning Outcome: 1.3 Identify the core functions of an electronic health record system.
Pages: 6-14
Teaching Notes:
Electronic communication facilitates team coordination by allowing for connectivity among providers, patients, medical devices, and external partners (pharmacy, insurer, laboratory, radiology). Medical records are integrated – within settings, across settings, and inpatient to outpatient.
Patient support involves access to educational materials and allows for family and informal caregiver education. Also, data can be electronically entered by the patient, the family, and informal caregivers.

18. 1.3 Functions of Electronic Health Record Programs (continued)
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Administrative Processes
PMPs and EHRs streamline billing, scheduling, and other administrative tasks.
Reporting and Population Management
EHRs also enhance reporting capabilities to make it easier to comply with federal, state, and private reporting requirements.
Learning Outcome: 1.3 Identify the core functions of an electronic health record system.
Pages: 6-14
Teaching Notes:
1. Administrative processes include scheduling management (appointments, admissions, surgery, and other procedures) and eligibility determination (insurance, clinical trials, drug recalls, and chronic disease management).
2. EHRs facilitate reporting for population management. This function relates to patient safety, quality reporting, public health reporting, and disease registries.

19. 1.3 Functions of Electronic Health Record Programs (continued)
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Advantages of Electronic Health Records
Safety
Reduced medication and physician order errors
Instant alerts about patient allergies and drug interactions
Alerts when medications are unsafe
No risk of records being lost due to a natural disaster
Improved communication related to an outbreak of a disease
Quality
Patients are reminded about preventive care screenings.
Patients are able to monitor chronic disease at home and report results via the Internet.
Patients can review data about quality and performance of providers prior to obtaining healthcare.
Learning Outcome: 1.3 Identify the core functions of an electronic health record system.
Pages: 6-14
Teaching Notes:
Safety: Errors are reduced in medication and physician orders (illegible handwriting); electronic alerts warn of allergies and drug reactions; alerts are available for physicians; record preservation is insured; timely communication of information is made possible.
Quality: Reminders can be sent to patients regarding preventative care and screenings, and patients with chronic illnesses can be monitored at home via the Internet.

20. 1.3 Functions of Electronic Health Record Programs (continued)
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Advantages of Electronic Health Records (continued)
Efficiency
Improved workflow in the physician practice or hospital
Speedy delivery of diagnostic test results
Ability for two or more people to work with a patient’s record at the same time
Never need to search for a misplaced or lost patient chart
Summary of patient’s health information available at a glance
Reduced time to refill prescriptions through electronic prescribing
All information available in one place
Payment for services received more quickly
Learning Outcome: 1.3 Identify the core functions of an electronic health record system.
Pages: 6-14
Teaching Notes:
Efficiency: Retrieval of information is immediate. This is essential in critical care situations. Efficiency also impacts workflow, refilling of prescriptions, receiving of payments, organization of records, and security of records against loss.

21. 1.4 The Medical Documentation and Billing Cycle : Pre-Encounter
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Medical documentation and billing cycle – a step process that results in timely payment for medical services
Learning Outcome: 1.4 List the step in the medical documentation and billing cycle that occurs before a patient encounter.
Pages:
Teaching Notes:

22. 1.4 The Medical Documentation and Billing Cycle : Pre-Encounter
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Step 1: Preregister Patients
Gather the following information to preregister patients before the office visit.
Name
Contact information; address and phone number
Reason for visit
Patient status (new or established)
Learning Outcome: 1.4 List the step in the medical documentation and billing cycle that occurs before a patient encounter.
Pages:
Teaching Notes:
Information for preregistration can be obtained by , by phone, or by mailing the patient the paperwork before the actual visit. Getting the patient’s information in advance provides the patient with good customer service and a better experience at the medical facility.
Have the students describe times when they received good customer service at a medical facility.

23. 1.5 The Medical Documentation and Billing Cycle: Encounter
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Step 2: Establish Financial Responsibility
Determine whether the patient has insurance and obtain the identification number, plan name, and name of policyholder. If the patient does not have insurance, establish the patient’s planned method of payment.
Step 3: Check In Patients
A patient information form is a form that includes a patient’s personal, employment, and insurance data needed to complete an insurance claim.
Verify identity by photocopying or scanning the patient’s insurance card and photo ID.
Learning Outcome: 1.5 List the steps in the medical documentation and billing cycle that occur during a patient encounter.
Pages:
Teaching Notes:
Show examples in your state of fee-for-service and managed care health plans. (Try United Health Group, WellPoint, Aetna, Humana, or Cigna—some of the largest.)
Have students describe plans in which they have participated and list what they liked or disliked about the plan.
Fee-for-service plans (also called indemnity plans) are more expensive than managed care plans.
Fee-for-service plans usually have deductibles and are more flexible than managed care plans.
Explain the importance of establishing financial responsibility early in the billing process.

24. 1.5 The Medical Documentation and Billing Cycle: Encounter (continued)
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Step 3: Check in Patients (continued)
Distribute Financial Policy and Privacy Policy.
Collect time-of-service payments.
Step 4: Review Coding Compliance
Diagnoses and Procedures
A diagnosis is the physician’s opinion of the nature of the patient’s illness or injury.
Procedures are the medical services provided.
Coding is the process of translating a description of a diagnosis or procedure into a standardized code.
A diagnosis code is a standardized value that represents a patient’s illness, signs, and symptoms.
Learning Outcome: 1.5 List the steps in the medical documentation and billing cycle that occur during a patient encounter.
Pages:
Teaching Notes:
Explain why the patient information form is important and why it should be updated periodically.
Ask the students how they would verify a patient’s identity.

25. 1.5 The Medical Documentation and Billing Cycle: Encounter (continued)
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Step 4: Review Coding Compliance (continued)
A procedure code is a code that identifies a medical service and is obtained using the Current Procedural Terminology (CPT). The CPT is the standard classification system for reporting medical procedures and services.
HCPCS codes are codes used for supplies, equipment, and services not included in the CPT codes.
ICD-9-CM is the source of the diagnosis codes used for reporting until October 1, 2014, and ICD-10-CM will be used beginning October 1, 2014.
An encounter form is a list of common procedures and diagnoses for a patient’s visit.
Learning Outcome: 1.5 List the steps in the medical documentation and billing cycle that occur during a patient encounter.
Pages:
Teaching Notes:
Describe the differences between diagnosis and procedure codes and why both are important in medical billing.
Give examples of ICD-9-CM and CPT Codes. Explain the conversion to ICD-10-CM.

26. 1.5 The Medical Documentation and Billing Cycle: Encounter (continued)
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Step 5: Review Billing Compliance
Each charge, or fee, for a visit is represented by a specific procedure code.
The provider’s fees for service are listed on the medical practice’s fee schedule.
Medical billers use their knowledge to analyze what can be billed on healthcare claims.
Learning Outcome: 1.5 List the steps in the medical documentation and billing cycle that occur during a patient encounter.
Pages:
Teaching Notes:
Explain what a fee schedule is and why providers may not necessarily pay what the fee schedule states.

27. 1.5 The Medical Documentation and Billing Cycle: Encounter (continued)
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Step 6: Check Out Patients
Medical codes have been assigned and checked.
Types of charges usually collected at the time of service include:
Previous balance
Copayments or coinsurance
Noncovered services
Charges of nonparticipating providers
Charges for self-pay patients
Deductibles
Learning Outcome: 1.5 List the steps in the medical documentation and billing cycle that occur during a patient encounter.
Pages:
Teaching Notes:
Have students discuss items that are filled in on an encounter form at check out.

28. 1.6 The Medical Documentation and Billing Cycle: Post-Encounter
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Step 7: Prepare and Transmit Claims
Once patient and transaction information is entered into the PMP, the software is used to create insurance claims.
A clearinghouse is a company that collects electronic insurance claims from medical practices and forwards the claims to the appropriate health plans.
Learning Outcome: 1.6 List the steps in the medical documentation and billing cycle that occur after a patient encounter.
Pages:
Teaching Notes:
Explain the relationship between accurate information on claim forms and prompt payment.
Also, explain how a clearinghouse “checks” the forms that are submitted for accuracy and what happens if they are not accurate.

29. 1.6 The Medical Documentation and Billing Cycle: Post-Encounter (continued)
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Step 8: Monitor Payer Adjudication
When a claim is received by a payer, it is reviewed following a process known as adjudication—a series of steps designed to judge whether it should be paid.
The document explaining the results of the adjudication process is called a remittance advice (RA) or explanation of benefits (EOB).
Each payment, RA and EOB is checked to see that:
All procedures are listed on the claim.
Unpaid charges are explained.
Codes match the claim.
Payment is as expected.
Learning Outcome: 1.6 List the steps in the medical documentation and billing cycle that occur after a patient encounter.
Pages:
Teaching Notes:
Refer to Figure 1.11 in the text. Go over it now in detail. This will help students later when they have to use the RA in the Medisoft exercises.

30. 1.6 The Medical Documentation and Billing Cycle: Post-Encounter (continued)
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Step 9: Generate Patient Statements
Statements list the services performed and the remaining balance that is the responsibility of the patient.
Step 10: Follow Up Payments and Collections
Revenue cycle management is managing the activities associated with a patient encounter to ensure that the provider receives full payment for services .
Learning Outcome: 1.6 List the steps in the medical documentation and billing cycle that occur after a patient encounter.
Page:
Teaching Notes:
Explain how the collection process works and why it is important to manage the revenue cycle. Have students describe processes that they would use to follow up on claims.

31. 1.7 The Impact of Legislation: HIPAA
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The Health Insurance Portability and Accountability Act of 1996 (HIPAA) contains a number of rules, including:
HIPAA Electronic Transaction and Code Sets standards
HIPAA Privacy Rule
HIPAA Security Rule
Final Enforcement Rule
Learning Outcome: 1.7 Discuss how the HIPAA Privacy Rule and Security Rule protect patient health information.
Pages:
Teaching Notes:
Have students discuss scenarios that might compromise HIPAA privacy rules.
Examples: Talking to friends about patients, talking on the phone to a patient within earshot of other patients, etc.

32. 1.7 The Impact of Legislation: HIPAA (continued)
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HIPAA Electronic Transaction and Code Sets standards
These describe an electronic format that providers and health plans must use to send and receive health care transactions.
The electronic transmission of data is called electronic data interchange (EDI).
Payment may be via electronic funds transfer (EFT).
Learning Outcome: 1.7 Discuss how the HIPAA Privacy Rule and Security Rule protect patient health information.
Pages:
Teaching Notes:
HIPAA Electronic Transaction and Code Sets Standards: Purpose is to reduce administrative costs and complexities by requiring use of standardized electronic formats for transmission of data.
EDI involves sending information from computer to computer using publicly available communications protocols.
EFT puts money directly into a designated bank account.

33. 1.7 The Impact of Legislation: HIPAA (continued)
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Claim Formats
The HIPAA-standard X Health Care Claim, or 837P for short
The CMS-1500 (08/05) paper claim
The National Provider Identifier (NPI) is a ten-position numerical identifier consisting of all numbers.
Learning Outcome: 1.7 Discuss how the HIPAA Privacy Rule and Security Rule protect patient health information.
Pages:
Teaching Notes:
Claim formats:
837P professional claim
CMS 1500 – Some small offices are exempt from the HIPAA requirement to send electronic claims, so they use this paper form.
NPI – Any individual or health care provider must have an NPI.

34. 1.7 The Impact of Legislation: HIPAA (continued)
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HIPAA Privacy Requirements
The HIPAA Privacy Rule protects individually identifiable information about a patient’s health and payment for healthcare that is created or received by a healthcare provider.
Rule mandates that
A set of privacy practices are adopted.
Patients are notified about their privacy and how their information can be used or disclosed.
Employees are trained to understand the privacy practices.
A staff member is appointed as the privacy official.
Patient records that contain health information are secured.
Learning Outcome: 1.7 Discuss how the HIPAA Privacy Rule and Security Rule protect patient health information.
Pages:
Teaching Notes:
HIPAA was enacted in 1996.
While the proliferation of health information networks provide many points of access to patient information, this also increases the possibility of unauthorized access.
Ask the students to explain why it is important to maintain privacy for patient information. Have them give examples.

35. 1.7 The Impact of Legislation: HIPAA (continued)
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Protected health information (PHI) is information about a patient’s health or payment for healthcare that can be used to identify the person.
The HIPAA Security Rule regulates the protection of individually identifiable information about a patient’s health and payment for healthcare that is created or received by a healthcare provider.
An Audit Trail is a report that traces who has accessed electronic information, when information was accessed, and whether any information was changed.
Learning Outcome: 1.7 Discuss how the HIPAA Privacy Rule and Security Rule protect patient health information.
Pages:
Teaching Notes:
3 categories of security standards:
Administrative – Management is assigned to one person.
Physical – Threats include hackers, disgruntled employees, or angry patients. Unauthorized intrusion is access by individuals who do not have a “need to know.”
Technical – Access is granted on a “need to know” basis. Passwords are designed to allow customized access.
Have students break into groups and develop a security plan for an assigned medical facility (i.e., doctor’s office, hospital, laboratory, etc.) Have them present their security plan to the class for discussion.

36. 1.8 The Impact of Legislation: HITECH and ACA
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The Health Information Technology For Economic and Clinical Health Act (HITECH) provides financial incentives to physicians and hospitals to adopt EHRs and strengthens HIPAA privacy and security regulations.
Act introduced additional privacy and security regulations, including:
Breach notification
Monetary penalties
Advanced enforcement
Learning Outcome: 1.8 Explain how the Health Information Technology for Economic and Clinical Health (HITECH) Act and the Affordable Care Act (ACA) promote health information technology and explore new models of delivering healthcare.
Page:
Teaching Notes:
Breach notification: This requires notification of patients by covered entities of any breach of information; it also specifies that the federal government and the media must be notified.
Monetary penalties: Penalties for breaches range from $100-$50,000.
Advanced enforcement: Office of Civil Rights is required to conduct audits to ensure compliance with HIPAA rules.

37. 1.8 The Impact of Legislation: HITECH and ACA (continued)
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Meaningful Use is the utilization of certified EHR technology to improve quality, efficiency, and patient safety in the healthcare system.
Regional Extension Centers (RECs) are centers that offer information, guidance, training, and support services to providers transitioning to an EHR system.
A Health Information Exchange (HIE) is a network that enables the sharing of health-related information among provider organizations according to nationally recognized standards.
Learning Outcome: 1.8 Explain how the Health Information Technology for Economic and Clinical Health (HITECH) Act and the Affordable Care Act (ACA) promote health information technology and explore new models of delivering healthcare.
Pages: 32-37
Teaching Notes:
EHRs facilitate evidence-based medicine by allowing physicians to share information quickly.
HITECH is part of the American Reinvestment and Recovery Act of A provider must show “meaningful use” of the EHR to qualify for the incentives.
Have the students explain why it is important to share information between providers.

38. 1.8 The Impact of Legislation: HITECH and ACA (continued)
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The National Health Information Network (NHIN) is a common platform for health information exchange across the country.
The Affordable Care Act (ACA) is federal legislation that includes provisions designed to increase access to healthcare, improve the quality of healthcare, and explore new models of delivering and paying for healthcare.
An accountable care organization (ACO) is a network of doctors and hospitals that shares responsibility for managing the quality and cost of care provided to a group of patients.
Learning Outcome: 1.8 Explain how the Health Information Technology for Economic and Clinical Health (HITECH) Act and the Affordable Care Act (ACA) promote health information technology and explore new models of delivering healthcare.
Pages: 32-37
Teaching Notes:
Have the students explain why they believe that the ACA and ACO were created. Then, tie the discussion back to the beginning of the lecture concerning the high cost of health care.

39. 1.8 The Impact of Legislation: HITECH and ACA (continued)
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The patient-centered medical home (PCMH) is a model of primary care that provides comprehensive and timely care to patients, while emphasizing teamwork and patient involvement.
Core Features include
Personal Physicians
Clinician Directed Medical Practice
Whole Person Orientation
Coordinated/Integrated Care
Quality and Safety
Enhanced Access
Payment
Learning Outcome: 1.8 Explain how the Health Information Technology for Economic and Clinical Health (HITECH) Act and the Affordable Care Act (ACA) promote health information technology and explore new models of delivering healthcare.
Pages: 32-27
Teaching Notes:
Have the students explain why they believe that a patient should be more involved in her healthcare. Review Figure 1-14 and have students give examples for each of the points referenced in the figure.