Community hospitals are a major provider of health care in the United States. A hospital is an institution that provides diagnostic, treatment, and therapeutic services to patients with the supervision of physicians. (Knickman & Kovner, 2014, p. 190-191). Community hospitals include short-term general hospitals: nonfederal not-for-profit, investor-owned for-profit, and government-owned public hospitals. (American Hospital Association, 2016). Not-for-profit hospitals are funded through the Centers for Medicare & Medicaid and may be operated by faith organizations, charities, and quasi-governmental boards and organizations. (Eiland, 2015, p. 10-11). For-profit hospitals may be a sole proprietorship, partnership, or corporation. (2015, p. 10). …show more content…
First, 3 to 5% of the population is high risk patients who have “at least one complex illness, multiple comorbidities, and psychosocial problems” that require complex, expensive care. (2013). Managers suggest hospitals provide low-cost intensive care management rather than expensive acute care, and coordinate care with other organizations. (2013). Second, 20 to 30% of the population is rising-risk patients who have multiple risk factors associated with chronic disease that require care to prevent worsening risk. (2013). Managers recommend providers eliminate underlying risk factors rather than simply treat the disease, which would essentially move hospital patients into medical homes for coordinate care. (2013). Third, 70% of the population is low-risk patients who have a well-managed chronic condition or who are healthy seeking “convenient access to the services they need the most.” …show more content…
As patients assume more responsibility for health costs in consumer-driven care models, hospitals are simplifying prices and billing statements. (Robinson & Ginsburg, 2007). Bills include all chargeable items in a charge master. (2007). The finance department modifies charges to earn profits, to respond to inflation, to account for expensive equipment and resources, and to survive competition. (2007). Hospitals adopt “pricing transparency” and provide more precise costs for specific services. The Health Care Price Transparency Promotion Act of 2007 “builds on existing state efforts to report hospital pricing information, requires insurers to disclose estimated out-of-pocket costs to consumers and requests that the Agency for Healthcare Research and Quality study the types of price information that consumers want and would find useful in making decisions.” (2007) The American Hospital Association supports these efforts and has “partnered with the Healthcare Financial Management Association on the Patient-Friendly Billing project to help promote clear, concise and correct financial communications.”
Furthermore, uncertainty of new reimbursement models, diminishing reimbursement, and complicated compliance regulations are playing the role of a catalyst for streamlining the Chargemaster process in majority of healthcare organizations. A good example of these challenges was prompted by the Center for Medicare and Medicaid with the release of data and chargemasters from several healthcare facilities. The release of the chargemasters sends a wave shock across the healthcare industry as it depicts a huge price discrepancies among health care providers, and due to this exposure many healthcare organizations attempt to rectify their charges. The main purpose the CMS release the chargemasters was to encourage transparency in hospital’s billing
The cost of Medical equipment plays a significant role in the delivery of health care. The clinical engineering at Victoria Hospital is an important branch of the hospital team management that are working to strategies ways to improve quality of service and lower cost repairs of equipments. The team members from Biomedical and maintenance engineering’s roles are to ensure utilization of quality equipments such as endoscope and minimize length of repair time. All these issues are a major influence in the hospital’s project cost. For example, Victory hospital, which is located in Canada, is in the process of evaluating different options to decrease cost of its endoscope repair. This equipment is use in the endoscopy department for gastroenterological and surgical procedures. In 1993, 2,500 cases where approximately performed and extensive maintenance of the equipment where needed before and after each of those cases. Despite the appropriate care of the scope, repair requirement where still needed. The total cost of repair that year was $60,000 and the repair services where done by an original equipment manufacturers in Ontario.
With the passage of the Affordable Care Act (ACA), the Centers for Medicare and Medicaid Services (CMS) has initiated reimbursement based off of patient satisfaction scores (Murphy, 2014). In fact, “CMS plans to base 30% of hospitals ' scores under the value-based purchasing initiative on patient responses to the Hospital Consumer Assessment of Healthcare Providers and Systems survey, or HCAHPS, which measures patient satisfaction” (Daly, 2011, p. 30). Consequently, a hospital’s HCAHPS score could influence 1% of a Medicare’s hospital reimbursement, which could cost between $500,000 and $850,000, depending on the organization (Murphy, 2014).
General Practices Affiliates is considering an offer from Titus Lake Hospital to join under a provider leasing model. Under a provider leasing model, Titus Lake Hospital is purchasing General Practices Affiliates’ services. The practice will retain control of personnel, management, and practice policies. Titus Lake Hospital submitted financial reports to assure transparency during the lease agreement process. The following analysis will discuss whether Titus Lake hospital is a viable financial partner for General Practice Affiliates, possible implications of the lease, and recommendations.
Memorial Medical Center was situated “three feet below sea level, which is on one of the low points in the bowl in New Orleans (Fink, Sheri, 2009).” This hospital served as a “shelter whenever hurricanes threatened: employees would bring their families and pets, as well as coolers packed with food (Fink, Sheri, 2009).” Having 2,000 people taking shelter in this hospital on top of 200 patients, and over 600 workers in one place during a category 5 hurricane, ran a huge risk. This was not something that was assessed, because the author stated, “this is something that citizens who live around the hospital normally do during a crisis like this (Fink, Sheri, 2009).” I also do not think that individuals believed that Hurricane Katrina would have been as bad as it was, because this is the storm that is considered to be a “lesson learned (President George W. Bush, 2005)”.
In almost 100 years, Miami City Hospital, led by civic leader and physician Dr. James M. Jackson, has developed from a small, 13-bed hospital to a comprehensive health systems with multiple clinics and hospitals, now named Jackson Health System (JHS).
Summit Oaks Hospital is a privately owned, for-profit hospital located in the affluent community of Summit, New Jersey. It is a 38-bed facility and is not associated with any other healthcare provider. Summit Oaks provides psychiatric as well as chemical dependency inpatient as well as outpatient treatment for both children and adults (Summit Oaks Hospital, 2016). Summit Oaks does not provide any other healthcare services; therefore, any patient requiring medical treatment secondary to psychiatric or chemical dependency issues is transferred to another hospital for treatment. Founded in 1902 the hospital has provided treatment to individuals in the entertainment industry as well as local citizen.
The situation at the Twin Oaks Hospital is a conundrum that every human resource function would not like to be involved. It is a scenario that has the potential to derail the services of the medical facility. The primary issue, in this case, is remuneration. Employees are demanding an improved wage system that reflects on the services that they offer. In the claims, there appears to be an array of disparities that the line managers must give a response. Seemingly, there have been some grumbles over the wage structure. Employees who give the same value of services are paid varying amounts of money. Ordinarily, if workers discover such a disparity, they are likely to stage a go-slow in protest. There is,
Huntsville Hospital (HH), located in Northeast Alabama, part of the Huntsville Hospital Health System, originating in downtown Huntsville, Alabama in the late 1800’s. As the not-for-profit, public hospital system developed, HH became the second largest employer in Madison County, Alabama with an estimated 7000 employees, 2000 nurses and 1000 physicians.
Varying in size, these companies act as a middleman between the patient and the medical facility finance office. All having slight variations, the abundance of insurers can cause confusion and often times incorrect billing. Insurance companies unlike individuals are able to negotiate a discounted payment with the hospital, but at a steep price. Of the considerable amount of money the United States put into the health industry, 35% of it went to paying for administration cost of both the insurer and the hospital (Brill,Steven, pg.34-43, Time). It should be no surprise then that the United States leads the world in every category of health care cost, often times charging twice more than the second most expensive country.
In order to fully understand the uninsured and underinsured problem that hospital administrators face the cause must be examined. The health outcomes of uninsured individuals are generally worse than those who are insured. Uninsured persons are more likely to experience avoidable hospitalizations, diagnosed at later stages of disease, hospitalized on an emergency or urgent basis, and more seriously ill upon hospitalization (Simpson, 2002) Because the uninsured often lack an ongoing relationship with a health-care provider, they are less likely to receive preventive care and diagnostic tests (Kemper, 2002). Many corporations balance their budget through cost cuts and other moves, but have been slammed with an increasing load of uninsured patients, coupled with reduced payments from government and private insurance programs. In 2000, 564,476 uninsured patients came through Health and Hospitals Corporations health care centers, a 30 percent increase from 1996. In the same period, Congress reduced Medicare reimbursements to hospitals, while Medicaid reimbursements to primary care clinics remained basicall...
In order to make ones’ health care coverage more affordable, the nation needs to address the continually increasing medical care costs. Approximately more than one-sixth of the United States economy is devoted to health care spending, such as: soaring prices for medical services, costly prescription drugs, newly advanced medical technology, and even unhealthy lifestyles. Our system is spending approximately $2.7 trillion annually on health care. According to experts, it is estimated that approximately 20%-30% of that spending (approx. $800 billion a year) appears to go towards wasteful, redundant, or even inefficient care.
Patients with chronic diseases do not receive established and operative treatments to help them successfully manage their condition. These complications are aggravated by an absence of organization of care for patients with chronic diseases. Nevertheless, the fundamental disintegration of the health care system is not unexpected given that health care providers do not have the imbursement support or other tools they need to interconnect and work together successfully to improve patient care (Brennan et al., 2009; Renders et al., 200;).
reimbursement determinations. As a result, the camaraderie among physicians has developed into a more aggressive approach to impede competition (Shi & Singh, 2012). Little information is shared with patients in regards to procedures or disease control. The subjects are forced to rely on the internet for enlightenment on the scope of their illnesses (Shi & Singh, 2012). Furthermore, the U.S. health care system fails to provide adequate knowledge on billing strategies for operations and other medical practices. The cost in a free system is based on supply and demand and is known in advance of hospital admission (Shi & Singh, 2012). The need for new technology is another characteristic that is of interest when considering the health care system. Technology is often v...
A hospital is an institution that provides medical services for a community. Hospitals can be looked at from many different aspects. The main ones are length of stay, kinds of service, and the type of ownership. Short-term hospitals make up most hospitals. The patients in these hospitals stay only less than a month. The community of a hospital make up how much recognition they might receive. Community and nonprofit hospitals always spend more money for patient care than they receive in fees.