AMT Task 3
Cassandra Davenport
ID:000366484
Program: MBA, Healthcare Management, 2/1/14
Mentor: Rusty Lynch
931-580-9182
Chapel Hill, TN Central Time Zone cdaven5@wgu.edu Current National Healthcare Trends and Policy Initiatives Affecting Healthcare Healthcare is in a constant state of change with movements that impact rates, access and quality of care. Hospitals have become more competitive due to the rising cost of care delivery and the reduction in reimbursement from payers. This causes difficulty in delivering quality care to all patients, which is being measured by mandated patient perception surveys, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS scores are part of value
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Bundled payments are a forerunner of what other payers will do and are already beginning to do in their contracts with hospitals. Mandatory outcomes reporting, such as core measures for Acute Myocardial Infarction (AMI) and Congestive Heart Failure (CHF) have also changed the way consumers select what provider they will choose, in addition to these quality indicators being part of the pay for performance initiative The aging population does pose the need for more physicians, including Cardiologists. According to Fye, (n.d.) “By 2001, there was increasing evidence that the supply of cardiologists was not meeting the growing demand.”
Impact
Because of the large amount of money associated with running this service line, the issue of payment will affect it very intensely. With the cardiac cath labs expected to cost $4,500,000 and the cardiac rehab expansion to be $500,000, the upfront expense will already cut into the bottom line. The service line will need to not only address education of the community, access into the system, preventive medicine and the latest technology, but it will need to be done as efficiently as possible. Moving patients through the system as quickly and efficiently as possible is also cost effective. Public reporting of core measures causes consumers to take their healthcare business to the facility with the highest score, without the understanding by the public of what the scores
The following is a summary of advantages and disadvantages of building, buying and leasing space for the new orthopedic line at Trinity Community Hospital. Included in this summary, is the option I recommend and my basis for this choice.
The open heart surgeries are profitable to hospitals, and even though the market was declining, if the hospital could capture some of the profit from these procedures, it would enable them to continue to make a profit. The hospitals in this area were all in competition for the ability to offer these services (George, 2002).
There will be a need for additional catheterization labs, surgical suites and expanded cardiac rehabilitation programs. There needs to be better coordination of care to ensure timely scheduling of procedures. Education programs need to be developed emphasizing cardiac risk factors, healthy living and lifestyle modifications.
Trinity Hospitals five year plan includes development of an orthopedic center, cardiovascular center and a cancer center. Task four asks for an assessment of the viability of one of these service lines. By assuming the role of the hospital CEO, I will evaluate the orthopedic center service line and present the findings to the board of directors for their approval.
Ransom, E. R., Joshi, M. S., Nash, D. B., & Ransom, S. B. (Eds.). (2008). The healthcare quality
With patients today using the threat of reporting low satisfaction rates in the hopes of receiving faster or higher quality care, they seem to have taken the upper hand in some of the decision making of what will take place in the healthcare world (Sullivan). But is it really the survey results that will make the drastic changes that are needed?
Through the history of health care, the standard of care changed from protecting our patient from injury and illness to a systemic entity to make money for insurance companies. Access to services and clinical outcomes are dependent on what health insurance providers will “pay” for in a clinical or community setting; as a result, patient safety, care and satisfaction has been negatively impacted.
What is the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and how can they improve the quality of health care that we receive when we go to the hospital? This paper will answer those questions and will also show why they are so vital to the healthcare industry.
Where there is transparency, there is good accountability thereby reducing government deficit. “Its past time to require transparency of cost and outcomes, so consumers can make informed choices about their care. As patient – consumers increasingly transition to high-deductible plans and other models that increase their cost exposure, they will demand more transparency and information for the choices they need to make. However, simply having some awareness that not every hospital is performing equally well and consumers should be making informed choices is an important first step towards a true market-based healthcare system”(Rita Numerof
A powerful force for change can be created by embracing transparency. According to the Department of Health and Human Services, “transparency is a broad-scale initiative enabling consumers to compare quality and the price of health care services so they can make their own informative choices among doctors and hospitals. This initiative is laying the foundation for pooling and analyzing information about procedures, hospitals and physicians services. In order to create value driven health care, there are four steps to turn raw data into
In the past 20 years, the percentage of AF-related hospitalizations has increased by 66%, which represents a significant impact for health care providers, with a total cost burden of approximately 13.5 billion Euros in Europe.170 This is mainly the consequence of increasing number of patients with cardiac diseases, coupled with the expanding segment of elderly patients and improved diagnostic tolls.186 Maglio et al. reported that over a 2-year period, an AF patient requires an average of 14 office visits, 12 outpatient visits, 2 admissions to hospital and one emergency department visit.196
Hospitals and health systems in the U.S. are experiencing a remarkable transformation in their business models directed from numerous influences that are projected to ultimately turn the industry around. Pressures include providers troubled with the quantity of services they are responsible for, to providers who concentrate on presenting high-cost services that give emphasis to sustaining healthy populations (Dunn & Becker, 2013).
Quality is one of the most essential elements of healthcare. As stated by the Agency of Health Research and Quality, “Everyday, millions of Americans receive high-quality health care that helps to maintain or restore their health and ability to function” (Agency of Health Research and Quality, 2014). Improvements have become vital to the success of health care organizations and in the Healthcare Quality Book, it is explained that quality in the U.S. healthcare system is not at the standard that it should be (Ransom, Joshi, Nash & Ransom, 2008). Although this has been a reoccurring issue, attempts to fix the insufficiency have been less successful than expected.
Quality measures are strategies that gauge, evaluate or compute health care processes, results, discernments, patient insight, and administrative structure. In addition, quality measures are frameworks that are connected with the capacity to deliver first-class health care and/or that are able to identify with one or more quality objectives for medicinal services. These objectives include: compelling, protected, effective, quiet focused, impartial, and opportune consideration. Quality measures can be used to measure quality improvement, public reporting, and pay-for-reporting programs specific for health care providers (CMS.gov, 2016). There are an assortment of quality measures in which health care organizations can use to determine the status of the care they are delivering. Many are appropriate, but few are chosen for this research paper. Among them are: National Health Care Surveys, Hospital IQR Programs, Scorecards, and Political, Power, and Perception/Data for Decision-making tools.
According to the National Committee for Quality Assurance (NCQA, n.d.), “HEDIS [Healthcare Effectiveness Data and Information Set] is a tool used by more than 90 percent of America’s health plans to measure performance on important dimensions of care and service” (para.1). HEDIS works by comparing all plans across an equal comparison field, as well as providing information regarding the quality of the United States’ healthcare sector. This data collection and quality improvement tool provides information to various groups involved in healthcare, such as health insurance companies, healthcare consumers, and employers who offer health insurance to employees. Not only does this tool use particular measures for health issues, such as