Recovery Audit Contractors and Electronic Health Records

It is important to note that the purpose of recovery audit contractors (RACs) is to conduct intermittent or one-time audits and review payments. It essentially detects, identifies, and corrects improper payments by utilizing effective monitoring systems as well as collecting overpayments on claims (Buchbinder et al., 2019). RACs, ensure the maintenance of an appropriate degree of compliance with requirements and criteria of billing, documentation, and clinical payment. Electronic health records (EHRs) are digital systems that collect, store and categorize health information about individual patients and populations (Buchbinder et al., 2019). The evaluation of the purpose of RACs reveals that it is a correcting checkpoint mechanism for healthcare operations, whereas EHRs are a library or database always available for reference and analysis. Healthcare has two sides, one is about money and resources, and the other is about health outcomes (Buchbinder et al., 2019). RACs ensure that Medicare works properly in terms of its finances, but EHRs provide data on its performance when it comes to the health of patients and populations.

Both EHRs and RACs have a significant impact on establishing performance incentives. RACs are necessary to set up the incentives for the financial sustainability of Medicare since the program cannot exist if it is excessively costly for the services it covers. RACs, ensure that every penny and dollar transacted is done so properly in accordance with the requirements. EHRs impact performance incentives by demonstrating the successes or failures of Medicare when it comes to health outcomes (Buchbinder et al., 2019). If a certain community covered by Medicare is experiencing a decline in health metrics without accompanying resource allocation changes, then it showcases decreasing performance of the health services for this group. Thus, both RACs and EHRs are essential to properly track and control the performance of healthcare providers.

Reference

Buchbinder, S. B., Shanks, N. H., & Kite, B. J. (2019). Introduction to health care management (4th ed.). Jones & Bartlett Learning.

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AssignZen. "Recovery Audit Contractors and Electronic Health Records." January 30, 2024. https://assignzen.com/recovery-audit-contractors-and-electronic-health-records/.

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AssignZen. 2024. "Recovery Audit Contractors and Electronic Health Records." January 30, 2024. https://assignzen.com/recovery-audit-contractors-and-electronic-health-records/.

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AssignZen. (2024) 'Recovery Audit Contractors and Electronic Health Records'. 30 January.

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