Hospital Supply Chains:
Past, Present, and Future
Coauthored by Jason Henry and Sharon Higgs
?2016. FedEx. All rights reserved.
Introduction
Hospitals managed to remain profitable throughout the years while adapting and complying with costly changes in regulations as well as increases in operating costs. They were able to accomplish this primarily through Medicare, Medicaid, and private insurance reimbursements for services. However, the latest health care reform initiative has reduced the percentage of reimbursements, especially for hospital inpatient services. Less reimbursements coupled with costly phased rolled-out regulatory requirements is forcing some hospitals out of business.
To stay
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Evolving Trends
Group Purchasing Organizations (GPOs) grew in popularity between 1970 and 1980. Concurrently, the larger for-profit hospitals were expanding their networks by acquiring the smaller not-for-profit hospitals. To remain competitive and reduce the risk of succumbing to take-overs by the for-profit hospitals, not-for-profit hospitals began to unite and form IDNs to reduce costs.
Over time, new healthcare reform measures were causing fundamental changes in reimbursement for services to hospitals and IDNs. Consequently, healthcare providers had to establish financial stability. This opened the door for third-party logistics providers (3PLs) to establish a strong presence in the healthcare industry. 3PLs? offered solutions to mitigate transportation and supply chain expenses that streamlined the order-to-delivery process and reduced expenses.
The introduction of the Affordable Care Act (ACA) will forever be recognized as legislative history. Conversely, the ACA has altered the landscape of the healthcare industry, albeit primarily impacting hospitals. Insurance reimbursement for hospital services rendered model is now determined on a ?quality of care? model and is determined by many regulatory nuances. The ACA is being incorporated in phases over a period of years because of the magnitude of change required to comply. Furthermore, the launch of the first phases involve a drastic reduction in reimbursement; while at the same the costs for
The ACA included reductions in Medicare payments to plans and providers and introduced delivery system reforms that aims to improve efficiency and quality of patient care and reduce costs including accountable care organizations (ACOs), medical homes, bundled payments, and value-based purchasing initiatives”(Cubanski & Neuman, 2016, p. 2).
The implementation of the Affordable Care Act has been everything but a smooth transition. The news media enjoys featuring issues found within its policies on a weekly basis. The frequent stories about policy holders losing coverage has the potential to mislead the American public into thinking the insured population is decreasing; however, the truth is that there is a growing problem in the patient to healthcare provider ratio within hospitals.
Finally, the ACA has encouraged and expanded the CMS department to test whether the reform and delivery models are working (Cassidy, 2010). This law gives CMS the right to change payment delivery and implement quality initiatives without having to go through the proper chains to seek approval. This initiative is often frown upon because at a moment’s notice, CMS can make changes. The ACA has helped Medicare to expand is sustainability for quite a few years, but initiatives have been passed onto the population monetary wise which has caused the people to become frustrated with the government.
When hearing the word “Overpopulation”, one tends to think about India and China and their massive populations, however it this is just the surface of the underlying hell that is these impoverished overpopulated areas. In Sold by Patricia McCormick, the reader is exposed to the dim reality of what happens in these crime ridden cities. The problem with these areas is that these poor living conditions affect millions of people daily, causing people to do things that they normally would not do to survive. The rapidly increasing populations in developing countries and cities is the main source of dehumanization in their societies.
While there has been large media coverage about the insurance impacts of the Affordable Care Act (ACA), there has been a smaller amount discussed of the law’s changes to provider reimbursement policy, reforms to the delivery system, and investments in programs to improve the quality of care and constrain long-run growth in health care costs. And yet, the elements included in the ACA directed at cost and quality is possible to affect the practice of care for nearly every provider across the country. Although cost containment policies and initiatives are largely applied through federal health programs which including Medicare and Medicaid; cost containment in these programs has important cost-saving spillover effects to private health care markets through changes in health care practices and pricing across sectors of care.
This paper works to review the Affordable Care Act (ACA) and its impact over the past 6 years. Through this paper, the Act enacted by President Obama in 2010 will be closely examined. The areas of focus in this paper are the conditions that led to reform, the key points of the ACA, and the impact the ACA has had on the country, and more specifically, the nursing profession. The first part will briefly explain the state of the country when the ACA was enacted. Later, within the key points of the ACA portion, this paper will identify important changes made to the health care delivery system, such as incentives, and the Pay-for-Performance (P4P) program. Finally, the paper will conclude by outlining the impact the ACA has had on the country, as well as on the nursing profession
The Patient Protection and Affordable Care Act, commonly called the Affordable Care Act (ACA), was signed into law by President Barack Obama on March 23, 2010 (CITATION). The ACA represent one of the biggest U.S healthcare system overhaul since Medicare and Medicaid passage in 1965 (CITATION). This reform was implemented to help consumers gain access to affordable health care coverage while also protecting them from abuse perpetrated by insurance companies. The goals of the ACA is to assure quality care, decreasing cost for the uninsured, and making healthcare available to all Americans. As a part of this quality care assurance, there is a mandated for positive transition of health care (CITATION). This brief will examine the factors that must be monitored in the implementation of ACA in order to promote the positive transition of health care and prevent re-hospitalization of this patient population.
In the hope of better coordinating the care of patients, improving quality and lowering costs, the ACA provides incentives for physicians and hospitals to work together in several ways, such as Accountable Care Organizations (ACO’s) or establishing bundled payments for episodes of care (Martin Gaynor, 2012 ) which has spurred consolidation (Becker, Gamble, & Rosin, 2015). Additionally, compliance with various federal programs such as Meaningful Use requires a significant investment in technology which can be fiscally challenging for smaller provider groups; driving acquisitions of these smaller entities by larger health systems. Other reasons cited by hospital administrators in the pursuit of consolidation is to ensure a steady stream of physician referrals (NPR, 2010), and to create economies of scale and increased efficiencies, the fruits of which result in reduced costs and therefore cheaper care for patients (ProMarket Writers, 2016). However, what most hospital
On March 23, 2010, President Barack Obama signed the Affordable Healthcare bill into law. There has been much controversy over this Affordable Healthcare Act before and since it was signed into law. It was estimated that 30 million people would sign up for the new healthcare and that the healthcare industry would need a bigger workforce. Within hospitals across the United States there is already a shortage of nursing and medical staff. What will this new law mean for hospitals in their declining health care professionals? In what other ways will this healthcare law impact hospitals across the United States? This paper will attempt to explore some of the realities and possibilities in greater depth.
The Affordable Care Act (ACA) legislated in 2010, has changed the United States health care industry. In addition to universal healthcare, one of the principles of the ACA is the ideal of accountable care. Specifically, adopting an Accountable Care organization (ACO) for Medicare beneficiaries under the fee for service program. An ACO seeks to hold providers and health organizations accountable for not only the quality of health care they provide to a population, but also keeping the cost of care down (1). This is accomplished by offering financial incentives to the healthcare providers that cooperate in, circumventing avoidable tests and procedures. The ACO model, seeks to remove present obstacles to refining the value of care, including a payment system that rewards the volume and intensity of provided services instead of quality and cost performance and commonly held assumptions that more medical care is equivalent to higher quality care (2) .A successful ACO model, will have developed quality clinical work and continual improvement while effectively managing costs, however this is contingent upon its ability to encourage hospitals, physicians, post-acute care facilities, and other providers involved to form connections that aid in coordination of care delivery throughout different settings and groups, and evaluate data on costs and outcomes(3). This establishes the ACO will need to have organizational aptitude to institute an administrative body to manage patient care,
Health care in the United States (U.S.) is driven by a makeshift of services and financing. Americans access health care services in diverse ways, from private doctors’ offices, to hospitals, and to insurance providers. The effects of the ACA will have numerous changes impacting hospitals and physicians practices. One of the main goals of healthcare reform is to reduce Medicare expenses by combining payment for services provided by hospitals, doctors, and nursing homes into one lump sum, which will effect
America spends 2.5 times more on healthcare than most developed countries yet still ranking 51st in life expectancy in the world (Baum, 2015). The Affordable Care Act (ACA) was implemented January 1, 2014 by President Obama to expand coverage to millions of individuals in need. It consists of two separate pieces of legislation: the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (Centers for Medicaid and Medicaid Services, 2016). Although the ACA will give health benefits to millions of uninsured Americans, hospitals are receiving less compensation because of the high demand of health care from over qualified recipients. Through the Children’s Health Insurance Program and also the Social Security Act, states are able to pilot a test approach that could extend coverage up to 200 percent of the poverty line (Sommers, Kenney, & Epstein, 2015). Such a large increase in the size of the population that is now eligible to apply for the ACA comes with a sizable amount of fiscal responsibility from the states and puts an immense strain on the amount of money guaranteed to pay for the services provided (Sonier et al., 2013). Given the lack of funding from the Medicaid program, absence of reimbursement strategies, and budget of healthcare in America’s Gross Domestic Product (GDP),
Although the ACA have made progress, many still question whether or not this new law is working. The law is too complicated for people to understanding their coverage. "The ACA is not perfect", "but at least" the U.S. has taken one step toward reducing the disparities between rich and poor and providing health coverage to everyone (Gruber, 2011). In this paper I will discuss the benefit of the ACA and the affect it will have on provider reimbursement.
Ernest Hemingway was an American writer. He was born in 1899 in Oak Park, Illinois. He committed suicide in 1961 in Ketchum, Idaho (Burges 17). Even today Hemingway is one of the most recognized authors in the world. Hemingway’s experiences during World War I are directly shown in many of his works. His general outlook on life is reflected in the adventures of his characters. It is clear that Hemingway had a desire to be part of the war even though, due to bad vision he was unable to enlist in the army and fight in the war. Instead he lied about his age and went to Italy to become an ambulance driver. While in Italy he experienced many things that he would later go on to write about in works such as A Farewell to Arms and For Whom the
When is lying ok ? I think lying is ok only when you are trying to protect someone or lie because you don’t want to get into trouble. I believe that lying is sometimes ok because you can lie so you won’t get into trouble or want people to think that you are telling the truth so you lie to your friends or family.