Organizational Analysis Paper

Competition is forcing consolidation of health insurers. Two years ago, there were fifteen major for-profit insurance plans that controlled the national market. They have consolidated into nine players, and further changes are predicted. (Singh & Sawhney, 2006)

According to Hospital Compare Cape Fear Valley Hospital is labeled as as “Worse than national bench mark” for CAUTI rates (Medicare.Gov, 2015)

I think it is interesting that in a few years Medicare will set a cap on surgery fees. For example, if someone needs a hip replacement the insurance company will only provide $35,000 to pay for all care that goes into the hip replacement. This provided amount will be the same for everyone that gets a hip replacement and the hospital will have to use its resources wisely to accommodate the difference.

With its 1,107 beds, Florida Hospital Orlando is recognized for its cardiovascular, gastroenterology, and other departments. They want to provide a world class care services to patients and family members. At Florida Hospital they believe there is an association

West Florida Regional Medical Center (WFRMC) located on the north side of Pensacola, Florida competed strongly with sacred heart and Baptist hospitals for patients. WFRMC’s CEO John Kausch was an active member of the Total Quality Council of the Pensacola Area Chamber of Commerce (PATQC) (McLaughlin, C.P., Johnson, J.K., & Sollecito, 2012).. PATQC’s vision was to develop the Pensacola, Florida area into a total quality community by promoting productivity, quality and economic developments in all area organizations both public and private (McLaughlin, et, al., 2012). John

Melnick, G., & Fonkycj, K. (2013). Fair pricing law prompts most California hospitals to adopt policies to protect uninsured patients from high charges. Health Affairs, 32(6), 1101-1108. Retrieved from http://ezproxy.nu.edu/login?url=http://search.proquest.com/docview/1372932073?accountid=2532

Due to such a small town, I am unable to find many options of accepted health insurance, so I will have to use the Blue Cross Blue Shield that I used in the first assignment to compare for Sandra Winters (my patient). Sandra is not old enough to qualify for Medicare and she does not meet the qualifications to receive Medicaid, therefore she must find a company that her local hospital and family doctor accepts.

Postsurgical infection treatment cost negatively impact hospital’s finance and creates a financial burden on the hospital. The financial burden of surgery is increased due to the direct costs incurred by the prolonged hospitalization of the patient, diagnostic tests, and treatment. “Infections related to coronary artery bypass graft (CABG) surgery are some of the most serious infections that require additional costs $40,000 to $50,000” (CABG Infections …, CMS Pay 2008). According to, Contemporary…, this serious and costly errors in the care delivery should never happen. Furthermore, “Hospitals can be penalized up to 1% initially of an organization’s baseline annual Medicare reimbursement” (Cherry, Jacob, 2017, p.392) for performing poor patient

The cost of obtaining health insurance in Florida has also received significant attention. Different demographic groups are considered higher or lower risk in terms of likely health costs, and health insurance premiums therefore vary according to a population’s risk profile. In Florida, risk groups are defined as counties, so premium costs vary between different counties. Premiums also vary based on a client’s age and the level of health insurance they choose. Bronze plans are the cheapest, but also provide lower levels of benefits, while the platinum plans are the most costly and provide the most extensive benefits. Depending on county, the cheapest silver plan for a single adult male cost between $227 and $318 per month in 2014. Premiums for similar plans rose to between $283 and $455 in 2017 (Born, 2017).

Not-profit driven hospitals spare more than $24 billion a year in government, state and neighborhood expenses. There are general rules that direct that these hospitals must give an advantage to the group, however there is no base necessity. Singular hospitals set their own arrangements. A patient that fits the bill for philanthropy care at one hospital may have their charges considered terrible obligation at another clinic.

After getting the views and suggestions all discuss this with hospital management and other stakeholders of the hospital to come with a reasonable prices which will make sure the health care provide by the hospital is affordable to everyone and is best quality. As much the patient may wish the prices to be reduced the quality of the health care cannot be compromised to the expenses of providing cheap health care. The prices being suggested should be in a position to support the normal functioning of the hospital.

These health sites are able to provide approximate prices for health services and procedures in fairly transparent format. Online resources are now being made available by insurers, government agencies, Internet companies and medical care providers. National insurers such as Anthem, United Health group, Humana, Aetna, and Cigna offer pricing tools to their customers. Some states including New Hampshire, Maine, Oregon, and Massachusetts offer pricing information. The internet company Healthcarebluebook.com prices products by are for all consumers in the United

Unfortunately, the prices for procedures are drastically higher in the United States but also the charges for similar procedures vary dramatically, even within the same geographic region (CMS, 2013). Costs of procedures and other healthcare services do not go up for no reason. Costs in health care increase due to more sophisticated technology and by people’s increased consumption of prescription drugs to name a few. Another driving force in increased healthcare services costs is waste. America is a land of waste, according to Berwick and HackBerth (2012) approximately thirty cents of every dollar spent on healthcare in the United States is wasted. It is wasted due to unnecessary services, tests and procedures ordered by providers, excessive

According to Proval (2014), patients whom are shopping in network for procedures are not always provided with most cost effective price within their market. The __ conducted a cost anylais to further analyze the cost variation throughout the country is vast even within the same city. For example, the price of an MRI (lower back) in New York City ranges from $416 to $4,527 (Proval, 2014). The patient whom

I did not give it much consideration in view of the fact that there are several hospitals and practitioners abound and you can just choose which doctor suits your interests and budget as well. Fees are straightforward for inpatient, outpatient, pharmacy and laboratory. Furthermore, since my husband