Hi, please, read and contribute to peer discussion in 75 or more words with at least 2 credible references in APA STYLE. Peer 1:

The AHIMA code of ethics not only provides guidelines on how to be an efficient health information management (HIM) professional, but it provides insight on being an overall good person. It also offers insight on how healthcare organizations can create a culture for HIM that fosters value-based care. For the most part key factors speak to honesty, advocacy, security, transparency, and many other noble acts that protect the rights of all healthcare recipients. That’s basically everyone.

In my current position I investigate Medicare fraud with regulatory guidance from the False Claims Act (FCA). Based on recent research the FCA protects the Medicare trust fund from being over-billed for healthcare products and services. Whether the act of fraud is done knowingly or not, violating providers can be penalized with substantial fines and/or criminal charges (oig.hhs.gov, 2021). The fee-for-service reimbursement model is prone to fraud, waste, and abuse because providers bill for every product or service prescribed in a patient’s treatment plan. Instances of overutilization and medically unnecessary treatment lend to billions of dollars in fraudulent claims. Certainly, the clinical codes that drive reimbursement put added importance and attention on having a coding compliance and ethics program in place (Bryant, 2018).

Based on recent research the principle of the AHIMA code of ethics that closely relates to my current work responsibilities is “refuse to participate in or conceal unethical practices or procedures and report such practices. Specifically, to not participate in, condone, or be associated with dishonesty, fraud and abuse, or deception like the following examples

• Allowing patterns of optimizing or minimizing documentation and/or coding to impact payment
• Assigning codes without provider documentation
• Coding when documentation does not justify the diagnoses or procedures that have been billed
• Miscoding to avoid conflict with others
• Engaging in negligent coding practices (library.ahima.org, 2019)

HIM professionals must be mindful of policies and procedures in place that protect recipients’ access to healthcare. Acts of fraud, waste, and abuse rob taxpayers of their hard-earned dollars. It also limits the number of providers available to treat patients and limits resources necessary to offer value-based care. My key takeaway from the AHIMA code of ethics is to treat others the way that you would want to be treated. That is truly the most ethical act that anyone could perform.

References:

American Health Information Management Association. (2019, April 29). AHIMA Code of Ethics. AHIMA Code of Ethics / AHIMA . Retrieved February 11, 2022, from https://library.ahima.org/doc?oid=105098#.YgbHed_MJD9

Bryant, G. (2018, May). Coding compliance and ethics: Make it work and be

Peer 2:A Code of Ethics is a professional statement that serves as a guide for the conduct of professional activities and decision-making. The AHIMA Code of Ethics, first and foremost, holds the confidentiality and privacy of health information paramount addressing it in the preamble as well as throughout the rest of the code (AHIMA, 2019). Other points seem to be aligned with the information technology aspect of the profession as they are geared toward the responsible and appropriate use of data, information, and information systems. The final points approach how to be a better professional in terms of representing the profession in a positive light, bolstering the profession by teaching and recruiting, and facilitating collaboration through the interdisciplinary nature of health information.

Of course, working in healthcare, one of the most pertinent items is the protection of confidential health information. Those working in the healthcare profession have a sacred trust to protect the information of patients. Even through data exchanges and collection for research, HIM professionals are charged with the protection of privacy, maintaining confidentiality, and ensuring data remains secure throughout the spectrum of health information systems (Oachs & Watters, 2020). The code also invites the responsible use of information technology systems, and as widespread as electronic technologies are in healthcare now, this also applies to nearly everyone working in healthcare in some capacity. Overall, the code uses general ethical principles present in healthcare and applies them specifically to the management of health information.

Resources

American Health Information Management Association (AHIMA). (2019). AHIMA Code of Ethics. https://library.ahima.org/doc?oid=105098#.YgautN_MIUF

Oachs, P. and Watters, A. (2020). Chapter 27, Ethical issues in health information management. Health Information Management Concepts, Principles, and Practice (6th Edition).

HCAD 640 Discussion, Organizational Costing and Profit Analysis below

Peer 3; Several studies has proven that there is a significant association between a healthcare unit’s excellent financial performance and enhanced patient care. Akinleye, McNutt and Lazariu in their article published on August 16, 2019 titled “Correlation between hospital finances and quality and Safety of Patients Care” states that hospitals under financial pressure may struggle to maintain quality and patient safety and have worse patient outcome relative to well-resourced hospitals. In their research conducted in 108 New York State acute care facilities on the hospital financial condition and the quality and safety of the hospital at the acute care hospitals, financially stable hospitals have highly reliable patient care systems and facilitate more significant resources for quality improvement.

Gang Nathan Dong further explain that the fundamental reason for this financial stability and improved patient care is that if hospitals have stronger financial stability, they would be better positioned to dedicate more substantial resources to enhance patient care (Dong, 2015). He continue by saying such hospital prioritize patient care quality above quantity, and will be better positioned to compensate talented health care workers, physicians, and nurses. On the other side, a lack of financial stability can lead to poor patient care since these institutions prioritize quantity over quality.

Having studied these researchers, it is obvious that a hospital with more profits could fund investment with debt, and pay higher, apparently to recruit more qualified nurses which will in turn increase quality of care. As much as the pursuit of profit motivates hospitals to improve both the quantity and quality of services they provide, a lack of financial strength may result in a lower standard of health care services, emphasizing the importance of monitoring the quality of care in hospitals with poor financial health (Dong, 2015). Thus, managing a healthcare organization through revenue generation and cost control is crucial for the sustainability of an organization.

Reference

Akinleye, D. D., McNutt, L.-A., Lazariu, V., & McLaughlin, C. C. (2019, August 16). Correlation between hospital finances and quality and safety of patient care. PloS one. Retrieved February 11, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6697357/

Dong, G. N. (2015). Performing well in financial management and quality of care: Evidence from hospital process measures for treatment of cardiovascular disease. BMC Health Services Research, 15(1). https://doi.org/10.1186/s12913-015-0690-x

Peer 4:Every industry needs funds in order to acquire necessary resources that will then be used to execute their particular function or service. Having said that, It is important for organizations in the Healthcare industry (being one of the biggest industries) to have a solid financial management system in order to ensure uninterrupted delivery of service. The primary goal of financial management in healthcare is to maximize the efficiency and value of the organization by planning, acquiring and using its available resources (Pink & Song, 2020). According to Strutner (2020), good financial management lays the groundwork for the three pillars of fiscal governance: (a) Strategizing, (b) Decision-making, and (c) Controlling.

In lieu of that, several studies have proven that having a healthy financial state correlates with delivering a higher quality of patient care. A study made by Akinleye et al (2019) revealed that financially stable healthcare organizations are more than able to maintain their reliable systems and has the ability to explore methods for quality improvement thereby resulting in increased reports of positive patient experience. Another article by Dong (2015) states that the increase in profitability, labor costs and financial leverage is directly related to the improvement of the quality of care a healthcare organization can provide.

These studies and many more only proves that financial management should be prioritized by healthcare administrators in order to ensure that the community they are serving will receive continuous delivery of quality healthcare.

Reference:
Akinleye, D. D., McNutt, L. A., Lazariu, V., & McLaughlin, C. C. (2019). Correlation between hospital finances and quality and safety of patient care. PloS one, 14(8), e0219124. https://doi.org/10.1371/journal.pone.0219124
Dong, G.N. (2015). Performing well in financial management and quality of care: evidence from hospital process measures for treatment of cardiovascular disease. BMC Health Serv Res. https://doi.org/10.1186/s12913-015-0690-x
Pink, G. & Song, P. (2020). Gapenski’s Understanding Healthcare Financial Management. Health Administration Press. Retrieved from https://account.ache.org/iweb/upload/Pink%20Song%208e%20chpt.%201-47cdeb51.pdf
Strutner, S. (2020, October 2). Financial Management Explained: Scope, Objectives and Importance. Oracle Netsuite. retrieved from https://www.netsuite.com/portal/resource/articles/financial-management/financial-management.shtml