Provide a brief overview of the organization you selected
United Healthcare Organization
The United Healthcare Organization is well renown non-profit making system in the United States of America, which was founded by Dr. Paul Elwood, a healthcare professional, and Richard Burke in early 1977. The core agenda of the two was to help the people live a healthier and create the innovative capacity to advance the healthcare service provider in the region. The organization, together with its business partner Optum have more than 160,000 employees, serves more than 85 million people in the globe, and all 50 states of America and other 125 countries. It has extended its arms in the provision of services to the United Healthcare Children Foundation, Optum, and United Health Foundation (Tilman,2015). The organization has formed its school, the Park Lane Elementary School, based in Philadelphia, thus ensuring the adequacy of staff in the organization.
Describe the tools used to enforce regulations
The regulations set can affect the delivery and administration of healthcare. The Health Insurance Portability and Accountability Act (HIPAA). It is a law that protects the individual who lost their job or changed their job by protecting their health insurance cover. It protects the patient’s data and forms civil and criminals charges for anyone violating. The Health Information Technology for Economic and Clinical Health Act (HITECH). The organization should ensure there is security compliance in their systems hence preventing patient’s information from authorized people.
The Medical Access and CHIP (Children’s Health Insurance) (MACRA Act) (Melo,2019). It an act that ensures the medical practitioners are well aid and the use of electronic records compliance well with security guidelines. The medical necessity states that the medical insurance cover will not cover individuals if one did not fall sick hence organization needs to be vigilant not to charge non-sick people.
Describe organization communication strategy
Communication is a core prerequisite for having a successful organization and promote employee engagement. An organization has various strategies to meet the need for top-level managers to lower-level managers and employees. Linking the organizational communication plan to the objectives, mission, and mission of healthcare is the first point. Involving corporate strategy is one way of remaining consistent in the industry. Another point, understanding their clients and patients, having an idea of what kind of patient one is dealing with enhancing excellent communication (Oostra,2016). Third, engaging all the employees in an organization involving all the employees in communication makes them feel proud that they are valued hence increasing patient satisfaction.
Fourth, the content created should be relevant; for proper communication, the topic of discussion should be of help and realistic the industry. Fifth, distributing the content using the right channel, the appropriate channel of communication should be used when communicating an idea from lower managers to top managers. Sixth, implementing the right communication technology, execution of the content will aid in knowing the effectiveness and its reliability. Lastly, measure the outcome, this will give a clear picture of the communication technique. Therefore, if the communication strategy is effective, the industry will adopt it.
Describe the organization’s strategies to align with health care regulations and laws
Every employee of the United Healthcare Company should protect the company by acting with integrity and abiding by the rules and regulations set by the healthcare system. First, acting with integrity, recognizing and dressing the conflict of interest in an organization so that there is smooth running of the healthcare system without violating the set rules and regulations (Oostra,2016). Secondly, being accountable, one should be responsible for the decisions made and cooperating with investigators if there is a presence of misconduct.
The third point is trustworthy; this can be achieved by reporting misconduct and non-retaliating from the policies. Fourth, privacy and information security, the organization should be in a position to protect the patient’s confidentiality and ensuring electronic recording technology does not under authorized personnel. Last but least, stewardship, the United Healthcare assets, and the environment should not be used for personal gains.
Explain the most significant task the organization uses to implement strategies to align with healthcare regulations and laws
The organization should develop policies that govern the behaviors of the managers and employees about the laws governing healthcare and attaining objectives and strategies. Plans are set rules, forms, or specific guidelines set to govern the implementation of the strategy in an organization. As such, policies aid the company in implementing strategy in various ways (Joshi et al.,2014).
First, it institutionalizes the strategy by supporting practices and operations carried out in the healthcare system. Second, policies reduce uncertainty in the execution of the strategy because each action is aligned with it. Third, it limits independent activities where there are clear explanations of how things are to be done. Fourth, it helps align actions and behaviors hence leading to correct decision making rather than breaking the rules and regulations.
Describe the challenges associated with ensuring compliance within the organization
When the primary goal of the regulatory laws is to provide quality healthcare, but many healthcare professionals feel the opposite of the intended objective, the healthcare laws, and regulations. They feel that the regulations are given more attention than patient quality care. The first point is the electronic breaches. Each different state definition of the personal information HIPPA and Data breaches act has become challenging to comply with since they have distinguished individual laws concerning persona data (Mariani, & Mohammed,2015). Secondly, containing too many policies in a given strategy, it becomes overwhelming for the professionals to adhere to each policy without breaking or forgetting what it entails, thus messing with its compliance.
False claims associated with non-compliance with the regulations, the company has gotten itself in non-compliance issues that were perpetuated by malicious people. As such, the company feels reluctant to do good in terms of following healthcare regulations. Last but least, the inadequate motivation of the employees leads to non-compliance, the staff should be offered training session that will help them broaden their skills and knowledge about the healthcare laws and the strategies set in an organization in support of organizational objectives.