...Financial Implications on Quality of Care Introduction There are many factors that can influence the quality provided by an organization. Conversely, it can also be be said that the quality of the services of an organization can have an influence over other factors as well. In this module, we look at how quality of care provided by an organization can carry major financial implications; that is, the importance of quality on the finances of an organization. In Module 4 we talked about how necessary technology is to the quality of health care. The importance on quality, not just quality of care, is just as important to the financial success of a health care organization. Many third-party payers (such as insurance companies) base reimbursement rates on the level of quality provided by an organization. For instance, the advent of EMR, discussed in Module 4, has made the process of coding and billing much more efficient and therefore saves time for third-party payers in their review of reimbursement requests. The decrease in the prevalence of errors greatly decreases the waste of resources for the health care organization also. A good quality improvement initiative within an organization also results in a more efficient means of operating the company which in turn can greatly increase the overall bottom line. The Balanced Budget Act of 1997 has also placed quality as priority as it relates to reimbursement of health care services. "Outcomes," a major component of quality, has become...
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...to use this information to improve performance (BusinessDictionary.com, 2014). Financial benchmarking is a tool that helps healthcare facilities identify their strengths and weaknesses that helps to reveal discrepancies between internal and external performances (Roop, Elizabeth, vol....
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...Financial Reporting Practices and Ethics in Healthcare Jeanette Jordan 03/07/16 HCS-405 Prof. Adrian Parker Abstract Financial management is a vital part of organizational effectiveness, it is a discipline with a long and respected history. Health care service delivery is a business, and the concept of financial management assists in balancing the inflows and outflows that are a part of the business. The managers within a health care organization will generally have one of three views the financial view, the process view and, the clinical view. Health care managers must of necessity interact with one another. Thus, managers holding different views will be required to work together. So, health care managers who understand health care finance will be able to interpret and negotiate successfully such interactions between and among viewpoints. (Mohamed Refaat, 2016) There are four elements of financial management planning, controlling, organizing and, decision making. In planning the financial manager identifies the steps that must be taken to accomplish the organization's objectives. Thus, the purpose is to identify objectives and then to identify the steps for accomplishing these objectives. In controlling the financial manager makes sure that each area of the organization is following the plans that have been established. In organizing the financial manager decides how to use the resources of the organization to most effectively carry out the plans that have been established...
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...Chapter One 1. A. What are some of the industries in the healthcare sector? The major industries in the healthcare sector includes health services, health insurance, medical equipment and supplies, pharmaceuticals and biotechnology, and other (includes a diverse collection of organization ranging from consulting firms to educational institutions to government and private research agencies. B. What is meant by the term healthcare finance as used in the book? Finance, as the term is used within the health services industry and as it is used in the book, consists of both the accounting and financial management functions. C. What are the two broad areas of Healthcare Finance? Accounting as its name implies, concerns the recording, in financial terms, of economic events that reflect the operations, resources, and financing of an organization. Financial management or corporate finance, provides the theory, concepts, and tools necessary to help managers make better financial decisions. Certain aspects of accounting involve decision making, and much of the application of financial management theory and concepts requires accounting data. D. Why is it necessary to have a book on healthcare finance as opposed a generic finance book? The reason is that while all industries have certain individual characteristics, the health services industry it truly unique. 2. What is the difference between a business and a pure charity? A business such as a hospital or medical...
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...organizations playing an integral part in the delivery of health care. Health care is provided by different health care financial environment namely for-profit organization (FP), not-for-profit organizations (NFP), and governmental organizations (Finkler & Ward, 2006). This paper will identify one entity from each health care financial environment identified from the previous week’s worksheet and will describe the financial structure of each financial environment. This paper will also address the policies that make this financial environment unique and identify which financial management practices are prevalent in the financial environment. This paper will also explain why effective financial management is more difficult in health care than in other industries. Entities FP, NFP, and government facilities exist throughout the country. This paper identifies the first entity FP healthcare organization JFK Medical Center. The second entity is Naples Community Hospital (NCH), a NFP healthcare organization, and the third entity is the Veterans Administration, a government funded facility. JFK Medical Center is a 460-bed acute care medical/ surgical hospital specializing in cardiovascular care, oncology services, neuroscience, bariatric, and orthopedics. It is located at the heart of West Palm Beach, Florida (“Jfk Medical Center”, n.d.). The NCH Healthcare system, a NFP organization, has multiple facilities consisting of two hospitals, dozens of medical facilities throughout...
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...demand for increasingly efficient health care organizations is essential to a positive outcome for the industry. Health care is one of the world’s most complex undertakings, there are innumerable processes at every level. For-profit Financial Environment For-profit organizations must make a return on investments and services rendered. They must meet their obligations and must satisfy private investors and shareholders (Finkler, & Ward, 2006). With a return on investment being one of the top priorities, motivation can be fostered to provide high efficiency with a superior product. In this case, a superior service. Mountain Star Healthcare Mountain Star facilities are owned and operated by the larger parent company Hospital Corporation of America (HCA). This private company began trading shares in the stock exchange in 2011 (Hospital Corporation of America, 2013). Their goal is to approach service expansions with the patient put first. Mountain Star is placing conveniently located outpatient clinics in the surrounding communities. These individual clinics might include imaging, surgery, and physician clinics (Mountain View Hospital, 2013). Unique Financial Policies For-profit organizations are treated as private corporations or a financial variant. Because they are private entities, they are subject to all...
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...The Innovations and Incentives in Healthcare Discussing the innovations that improve the healthcare system and financial incentives. Furthermore, do financial incentives increase the quality of care that patients receive from physicians? Understanding the cost and complications when it comes to innovations and financial incentives in the healthcare system. Also, examining the Medicare/Medicaid payments that physicians receive based on the quality of care to patients. Finally, what can help the federal government come up with ways that help improve and expand the comprehensive healthcare laws? Innovation for Healthcare Innovation can be a challenge in the healthcare system for the healthcare professions and patients. Innovation is very crucial...
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...1.1 a. what are some of the industries in the healthcare sector? * health services, insurance, equipment, supplies, drugs, and technology related to healthcare b. what is meant by the term health care finance as used in this book? healthcare finance is about accounting and financial management in healthcare. it provides organizations and managers with information as to help them make better financial decisions. c. what are the two broad areas of healthcare finance? * Accounting and financial management d. why is it necessary to have a book on healthcare finance as opposed to a generic finance book? - healthcare business in different than general business. healthcare services are mostly from not for profit corporations, which work with the normal investor owned corporations. because of insurance it also has third-party payers. 2. what is the difference between a business and pure charity? -businesses try to make profit, invest in its business. Charity work is non profit, and don’t make their revenue by selling their services. 3. a. briefly discuss the role of finance in the health services industry. -Finance is used to maximize efficiency and value. Also to implement cost controlling strategies. b. has this role increased or decreased in importance in recent years? increased. before healthcare used to make high profits and revenue, now its not so easy to be successful. finance is important and negligence in this department...
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...2-17-16 Healthcare in America is changing at a rapid pace. The last time healthcare was moving this fast it was during the time that Medicare was launched. In this nation twice as much money per person is being spent on healthcare. The U.S. had the lowest score overall in quality, access, efficiency, equity, and healthy lives when in comparison to six other nations. There was also a lack of good chronic care management, care coordination, safety, and also the use of information technology. “The Supreme Court’s decision in June to largely uphold the constitutionality of the patient protection and affordable care act will mean the health reform implementation will proceed at a rapid pace” (healthaffairsblog). The congressional budget office plans to have about 23 million people insured by 2022. “New federal financial opportunities including the Medicare shared savings program, dual-eligible demonstrations pioneer accountable care organizations bundled payments, and numerous primary care initiatives are setting the stage to reward healthcare providers for patient care that is higher quality, more efficient, and more effective overall” (healthaffairsblog). In today’s society there is a fee-for-service payment model that rewards doctors and hospitals based on the service rather than the quality. Patients have little to no information about health cost and quality. There are many efforts to fix these problems so that each person has the information, tools, and financial incentive...
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...Coventry Health Care, Inc. became a public company in 1991, and is currently listed on the NYSE with ticker symbol "CVH". Since the company’s inception, the building blocks of “The Coventry Model” have remained financial discipline and service excellence. The company’s senior management team has long understood those two objectives need not be mutually exclusive. As an organization, our long-term success depends on the ability to translate our commitment to affordable and accessible health care into real change. We look to four principles to guide us as we strive to provide exceptional value for members, employers, and providers: Easy and Simple Experience Everyone at Coventry is uncompromising in their commitment to ensure that all our customers have an easy, simple, and productive experience – whether enrolling as a new member, refilling a prescription, or filing a claim. Operational Excellence We pay fanatical attention to operational excellence, continually refining the advanced platforms and processes that are essential to what we do: delivering a growing range of services in the most efficient, cost-effective way possible to an ever-larger number of people. Financial Discipline At every level, we guard our financial resources scrupulously, knowing that financial discipline provides the foundation upon which we can deliver products and services with great value. Empowering Environment Underlying the performance in each of...
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...Running head: Healthcare Funding Sources and Financial Planning HCM410-1401A-02: Fiscal Management in Healthcare Services Phase 1 Individual Project Healthcare Funding Sources and Financial Planning Andretta Hill Colorado Technical University Online Professor Jeremy Howell January 14, 2014 Impact that Medicaid cuts has on Krona’s revenue Like many health care facilities, Krona Community Hospital will be affected by the cuts to Medicaid. Medicaid is the largest sources of revenue for many health center to include Krona Community Hospital. The impact of the Medicaid cuts cannot be overstated. Medicaid cuts will not only affect providers, it also affects patients, their families and the economy. Medicaid, a large source of revenue for Krona Community Hospital, give them the ability to serve the low-income population more. Cuts to Medicaid not only hampers the ability for the health care facility to provide care to many patients, it also puts a hamper on the ability for the health care facility to expand. With all the changes to Medicaid in the last several years, payments from Medicaid have affected the ability for health care facilities to survive significantly. Cuts to Medicaid has caused many providers to refuse to see Medicaid patients due to reduced reimbursements. Medicaid provides for a large proportion of the revenue for many health care facilities to include Krona Community Hospital. They have to protect their pay rate for services...
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...STAFF MOTIVATION AT SHARP HEALTHCARE Sharp Healthcare is an integrated regional Healthcare delivery system located in San Diego, California accounts to serve approximately population of three billion. It comprises of four acute care hospital, three specialty hospital and three medical group plus a full spectrum of other facilities and services. The first Sharp hospital opened in 1955 as Donald N. Sharp Memorial Community Hospital, a nonprofit facility in San Diego. It operate 1,878 beds, has approximately 2600 physician on medical staff , more than thousand physician in two affiliated medical group, and has more than 14,000 employees with $ 5.852 in assets and $ 1.9 billion in annual income. It is San Diego’s largest private employer. Sharp HealthCare is recognized for its commitment to clinical excellence and high-quality patient care by local and national organizations. In 2008, Sharp Healthcare ranked fifth in the California “ best places to work program” in the large employer category and was rated 47th out of top 100 places to work in united states by modern healthcare. Roughly 10 years ago, Sharp HealthCare began a process of self-examination to explore how it could best deliver top-quality health care in the new millennium. After conducting more than 100 focus groups with employees, physicians, and patients, the group reconceived its mission to become an ideal healthcare delivery system and a model...
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...In contemporary healthcare, what is the role of information systems on productivity? Table of Contents Introduction 1 Literature review 2 Problem analysis and discussion 3 Electronic Health Records (EHR): 4 Computerized physician order entry (CPOE): 8 Conclusion 9 Recommendation 10 References 11 Introduction The healthcare industry is undergoing a drastic change in the modern world where the imprints of information technology (IT) are expanding and the combination of these two industries is leading to a new era of computerized hospital information systems. Baker (2008). The importance of information technology cannot be over emphasized for two major reasons, first, where a high level of accuracy is required (which can be fulfilled by digital mediums) and second, where a large size of transactional data exists and the requirement of analyzing this data supersedes (which can be fulfilled by having large databases and analyzing them using IT tools). There are numerous IT based applications in the environment and it has really become a challenge for the CTO of a healthcare facility to decide over the progressive plan for adoption of IT based systems in the purview of health information technology (HIT), computerized physicians order entry (CPOE), electronic health record (EHR) and many other similar programs found across the world. The primary question raised against any kind of IT investment is “how the proposed IT system will improve productivity...
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...University of Phoenix Material Week One Health Care Financial Terms Worksheet Understanding health care financial terms is a prerequisite for both academic and professional success. This assignment is intended to ensure you understand some of the basic terms used in this course. Complete the worksheet below according to the following guidelines: In the space provided, write each term’s definition as used in health care management. You must define the term in your own words. In the space provided after each term’s definition, summarize a health care management scenario that illustrates the importance of the skill, concept, procedure, or tool to which the term refers. In the scenario, you may wish to consider the following: o Why is the skill, concept, procedure, or tool necessary for accurate record keeping, operational efficiency, excellent patient services, employee management, regulatory compliance, reducing costs, forecasting, and so forth? o What successes are enabled by an adequate understanding or appropriate application of the skill, concept, procedure, or tool? o What risks or failures are associated with an inadequate understanding or inappropriate application of the skill, concept, procedure, or tool? Save the completed worksheet as a Microsoft® Word document with your name in the file name. Submit the file to your instructor. Worksheet Submitted By: [Kim Benke] |Term |Definition...
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...understand the state of the hospital, create value, increase efficiency, and turn the facility into a local hospital of choice. Whenever you are making visits in the various wards to meet the employees and the patients, you hear how the patients love the hospital, but they would like to see certain improvements in care. The employees seem to be very busy executing their duties and not interacting much with the patients. The hospital board has asked you to compile a report of your findings and suggested strategy for achieving the hospital’s current goals. Five Measurements of Quality Care in a Hospital Patients are the most important aspect of healthcare organizations. Without clients needing their services, healthcare facilities cannot function. Therefore, there are certain measurements of quality care that customers seek when choosing a healthcare facility during times of emergency and even an inpatient care facility. Quality of care can be broken down into three main categories, structural, process, and outcome measure (Bajnok, Puddester, MacDonald, Archibald, and Kuhl, 2012). The structural measures of quality are actions taken either by the organization itself, or by an individual that have significant influence on the overall quality of the organization’s performance (Bajnok, Puddester, MacDonald, Archibald, and Kuhl, 2012). Process measures of quality consists of the means of carrying out the work of the organization, while outcome measures of quality are measured by the results...
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