...Running Head: IMPROVE FINANCIAL PERFORMANCE IN MIDDLEFIELDImprove financial performance in Middlefield | | Health Service Systems Professor: Julie DennisDeVry/Keller University Online | 2/8/2015 | | As CEO of Middlefield Hospital for 2 ½ years now, I analyzed, observe and came up with a plan of execution to finally rectify the current workforce challenges that not only burden but also tormented the hospital when I first arrived. Recently meeting with the chief of financial officer (CFO), documentation was presented, regarding the hospitals financial performance and how it’s worsen for the past 6 months. Because of the financial performance is not meeting the hospitals standards the (CFO) as well as myself are concerned regarding the future of not only the hospital but also the committed employees it has. Another important matter that was also presented during the meeting, the new hospital across town and cutting into our market share by admitting more patients, causing the uninsured patients to seek Middlefield hospital healthcare. Middlefield Hospital is not the first to face such hardship, as CEO it is my responsibility to implement a game of execution to better serve patient care as well as safety, help correct medical errors if needed, but most importantly help to motivate all staff members and a good way to do that is changing up the operational strategy and when it comes to hospital culture nothing is of importance as the patients as well as employees who have...
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...of care at higher costs to one that promotes high-quality care at reduced costs led to the idea of pay for performance and public-reporting quality initiatives. (Calikoglu 2012) Studies have shown patient benefits resulting from pay for performance initiatives to be varied, and one of the key determinants in that variation is the healthcare setting itself. Another key determinant is the design of the pay for performance incentive, such as what aspect of performance is awarded, as well as the size of the reward. Studies have also shown that public reporting initiatives, or requiring hospitals and physicians to provide data on their own performance, have been effective in reducing preventable injuries in the hospital setting. (Leake 2010) There are two types of pay-for-performance initiatives that have been implemented in recent years: processed-based performance measures and outcome-based performance measures. Processed-based performance measures indicate whether protocols were followed in specific situations. For instance, whether or not patients with acute myocardial infarction received aspirin upon arrival to the emergency department is a process-based measure. Outcome-based performance, however, is measured based on patient outcomes, mortality rates, for example. Studies have shown that patients gain the most value from pay-for-performance initiatives in the hospital setting. The two main studies corroborating this claim are Maryland’s Quality-Based Reimbursement Program...
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...Balanced Scorecard: Measuring performance of an organization involves studying its processes and outcomes to see if it is getting the results it intend to achieve. The best way to determine operational effectiveness is by measuring business performance. There are many methods of measuring performance but the goal is the same — to find out what is working well and what needs to change. Performance measurement can keep a firm on track towards its vision and help achieve its objectives. Balance Scorecard (BSC), an important measure of an organization’s performance is defined as “a document that translates an organization’s mission and strategy into a comprehensive set of performance measures that provides the framework for implementation of its strategy”. A Balance Scorecard strikes a balance between financial and operating measures, links performance to rewards, and gives explicit recognition to diversity of organizational goals. In its simplest form The Balanced Scorecard breaks performance monitoring into four interconnected perspectives: • Financial perspective: Highlights achievement of financially strategic goals, including continued maximization of shareholder value and reasonable return on invested capital for business enterprises. • Customer Perspective: identifies the targeted market segments and measures the company’s success in those segments. It includes customer’s perception of the business, satisfaction, and other value added measures. A non-profit will look to...
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...To remain competitive with the new facility across town and retain patients, we must first look at our budget. Some competition will be great; as the competition rises both hospitals will provide better quality care at a decent price, which in the long run will benefit patients health. Look over the data collected of services doing well and how can we improve where we are failing. First, we must look at the managed care contracts that over due and appoint someone to maintain in contact with the manage care companies. Improving on our quality and making quality a high priority will increase our performance. Also, I will sit down with Barbara who is the Director of Quality Improvement and brainstorm over ideas that would help improve our quality care. We can do a survey with the staff members to come up with different ideas that would improve quality without wasting time on data that isn’t beneficial to the hospital. One way to improve our quality is to improve our process of how we serve our patients, being able to decrease the wait time from being check in and to seeing the doctor. This could lower the costs plus increase the satisfaction of patients and workers. This process dissatisfies patients and it is much easier to retain current patients than to find new ones, so keeping the patients satisfied is extremely important. Adverse errors are not only costly in terms of patient safety and additional costs to revenue streams and it is essential to increase nurse satisfaction...
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...Financial Ratios Analysis and Comparison Paper Dianne Davis MHA 612 Professor Johnson June 7, 2014 Abstract It is important for healthcare organizations to understand their present performance and weak areas in order to generate more effective operational strategies. Financial ratio analysis is an effective tool to determine hospital’s performance on several indicators such as ability to pay debt, capability to generate revenue, and sales performance etc. The objective of this paper is to describe role of different financial ratios in understanding organizational performance and in developing new strategy. The paper also presents comparative ratio analysis of local healthcare organization and industry norms. Financial Ratios Analysis and Comparison Paper Introduction Financial planning and effective management play a major role in success of healthcare business. Financial ratio analysis refers to an effective financial management tool that helps in understanding financial performance of the hospital over a period of time. Financial ratio informs about the financial trends and information on key performance indicators that helped in strategy making. Financial ratios can also utilize in comparing business performance of two or more hospitals, and also to assess effectiveness of management. Financial ratios utilized in measuring liquidity of the hospitals, profit evaluation, debt structure, management of cash flow, risk determination...
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...for Performance University of Phoenix Lori Stemen October 28, 2013 Reimbursement and Pay-for-Performance The United States has gone through some dramatic changes over the last forty years and currently we are in the middle of some additional changes with the Affordable Care Act. Pay-for-performance is intended to improve the efficiency, quality, and the overall worth of health care. The expectation is that these changes will provide to physicians, hospitals and other health care providers with financial incentives to finance improvements and accomplish improved results for the patient. There are positive and negative affects of the pay-for-performance programs, although we can’t predict the future and the outcome of these initiatives, the health care system will definitely feel the pressure to perform with respect to outcome accountability. With the continuous changes of government regulations the pressure to provide reliable high quality health care will increase. Pay-for-performance is the newest regulatory effort in health the insurance industry. Health care providers who participate with the insurance carrier are compensated for meeting pre-set goals for how they deliver health care services. This is an important modification from the fee for service method of payment. Pay-for-performance has been well liked by politicians as well as, Medicare, Medicaid and private insurance companies. The Affordable Care Act increases the usage of pay-for-performance methodologies...
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...practices in the NHS and how we can improve the performance of the hospital within National Health Service. So that, the CEP researchers do a survey of clinicians and hospital managers that show, how well are NHS hospitals managed - and what could be done to improve this? Also the author mentioned that there is a significant different in the performance of hospitals within NHS, also the measure used and the all indicators show a wide spread of performance between hospitals. Moreover, as the author mentioned that the variation in performance parallels other parts of economy. In addition, they do a new study and they apply to hospitals a modified version of the methodology for measuring management practices that we have used successfully in the manufacturing and retail sectors. Also they do another study and they interviewed doctors and managers in orthopedics and cardiology in acute hospitals in England, using an evaluation tool that defines and scores 18 different management practices from one to five. And the author mention that they score management practices within three broadly defined areas which is Monitoring, People and Target setting. The author shows that they did an interview for 161 clinicians and managers and they got a high response rate 61% of all acute hospitals in England. The author indicates that the better clinical outcomes, shorter waiting times, better financial performance and higher staff satisfaction always will be at hospital with higher management scores...
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...Running head: FINANCIAL PERFORMANCE Financial Performance Albert Solano Keller Graduate School of Management This paper will analyze some of the strategies and recommendations that will improve the financial performance of Middlefield Hospital that has seen some dramatic issues taking place financial wise over the past 6 months that is a great concern for the chief financial officer. Over the past 6 months Middlefield Hospital has been dealing with deteriorating financial issues that can be placed on several issues that have been noted. The budget has taken a big hit due to the new facility across town admitting more patients and this has declined the number of patients being seen at our facility. The number seems to be dropping by the month, and more uninsured patients are seeking services here at our facility. The payer mix of Middlefield Hospital is creating an overall reduction of reimbursement and net income for the hospital because more and more patients is comprised of Medicare, Medicaid, and uninsured patients. The facility across town is a very big competitor and seems to have opened a wellness center that offers its patients many different preventative and wellness services, and is attracting young families to seek care at their facility. In order to stay ahead of the competition Middlefield needs to make some changes in its operations and make a big effort to implement some strategies to improve its overall...
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...Pay-for-Performance Paper Patricia Vandermark HCS/531 November 3, 2014 Connie Melton Reimbursement and Pay-for-Performance Paper The arena of health care has always been constantly fluid, dynamic, and extremely challenging. As health care providers we struggle with the increasing demands of our institutions, the increasing demands of our patients, and most recently the demands that are a direct result of today’s health reforms. Since the inception of The Patient Protection and Affordable Care Act (ACA) of 2010 (Obamacare) our health care system has been challenged with the demand to improve health care quality and patient satisfaction while reducing costs. The United States health care system is evolving from a fee-for-service to a fee-for-outcome or pay-for-performance model. Not since Medicare and Medicaid were signed into law in 1965 has there been such a significant overhaul of our health care system. In this paper, I will discuss the "pay-for-performance" strategy and how it is intended to improve the quality and efficiency of health care. Definition pay-for-performance "Pay-for-performance" is an umbrella term for initiatives aimed at improving the quality, efficiency, and overall value of health care (Robert Wood Foundation, 2012). Financial incentives are offered to hospitals, physicians, and other health care providers and facilities if certain predetermined quality or performance measures are met. The pay-for- performance model also may impose financial penalties...
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...Health Organization (WHO) (2015) reports that the life expectancy at birth for Ethiopia is currently 65 (from 45 in 1990), ranking the country amongst the top six countries where life expectancy increased the most. Financing Public Health Care The Ethiopian health care system is structured into a three-tier system: primary, secondary and tertiary level of care. The primary level of care includes primary hospital, health center and health post. The Primary Health Care Unit (a health center and five satellite health posts) provides services to 25,000 people. A primary hospital provides services to an average population of 100,000 while a general hospital serves one million people (FMoH, 2015). The past twenty-year Health Sector Development Program was organized using the concept of decentralization and community ownership. The country’s leading program, called the Health Extension Programme, provides cost-effective basic services to the citizens using over 38,000 health extension workers (two for each village) deployed to train households to propagate healthy behaviors and to improve access to health services (USAID, 2016). The...
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...The vice president of human resource is liable to play a huge role for the successful administration of any organization. I got the realization of this fact when I was designated as the VP of HR in my hospital. Since after this promotion, the challenges o and responsibilities of my job had been increased considerably. Therefore, obviously besides providing the solutions of the problems, I am also expected to out forward new ideas as to enhance the productivity of the workers. Human resource is the biggest and most valuable asset for every organization. In fact, according to the beliefs of many businessmen, a sincere workforce is more important than the huge investments, if a company wants to progress in business. Human resource acts like the wheels that enable an organization to move towards its goals. If the human resource is withdrawn from an organization, the whole system will be stopped because there will be no one to perform any task in the latter (Compensation’s Role in). As a result, it gets highly critical for the organizations to be strongly concerned with the workforce related issues. Every organization, irrespective of its nature or type, is bound to remain careful and vigilant when it comes to cope with the problems of its human resource. This is all that I have come to conclude after the vast experience I have had as VP of HR. Quite obviously, it is practically not possible for any organization to absolutely come up to all the expectations of the workers...
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...Organization (PSO) was designated by the Affordable Care Act to assist Hospitals with relatively high readmission rates to reduce the number. Readmission is defined as an admission of a patient to the hospital within 30 days of the date of discharge. According to the Centers for Medicare & Medicaid Services (CMS), University Hospitals was on the list of high readmission rates, with an AMI of 21.8, HF of 26.6, and a total of 1328 of discharges. There are many resources available on reducing unnecessary hospital readmissions, for example, the ProjectRED, which “can reduce readmissions by integrating better communication among clinicians and patients and by instituting follow-ups after discharge” (CMS). However, one important approach was to improve the transition process in inpatient and outpatient care for UH. By setting up a detailed and enforceable action plan to improve continuity of care, UH should focus on the following aspects: the compliance of national safety goals and regulations, the quality of transition approaches, the follow-up of regular reexamine, etc. These are not only methods to avoid high readmission rates, but also techniques to improve patient satisfaction and to reduce unnecessary administrative costs. Furthermore, another plausible approach is to bring closer relationship between hospitals and patient families, since they are an important part of patient satisfaction. Pay-for-performance Based on CMS. ACA established a value-based purchasing program,...
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...Quality Performance – Course Project 3 Name Institution Quality Performance – Course Project 3 Using the course work, it is imperative to understand further the issue facing Ever Event Hospital and measures of mitigating them. It is important to comprehend the cause of the poor quality of care with reagrds to the previous assignment analysis conducted in project-1 and 2. This will be achieved through building on the quality management plan created using the three steps of the Schwart’s Cycle—Do, Check, and Act. It is also crucial to develop balanced scorecard specific to the improvement plan through the description of performance measurement tools. Four categories of measurement will be created; both clinical and financial as well as description and justification of each. For every group, three specific measures will be established together with their calculation with respect to performance measurement as well as an explanation of performance change if the analysis is done for the entire organization. Moreover, during the discussion, there is a need to cover issues to be considered in the implementation of program improvement, collection and analysis of data, and description of desired results of the quality improvement plan. PART I Through the use of Schwart’s cycle checklist, it is possible for one to solve the issue faced within Ever Event Hospital by utilization of ‘Do,’ ‘Check,’ and ‘Act’ categories (Kizer, 2008). Schewart‘s PDCA cycle is usually used...
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...The U.S. Healthcare System Non-Profit Versus For-Profit The U. S. healthcare system is generally made up of two classifications. Hospitals may either be classified as non-profit or for-profit institutions. The majority of the hospitals within the United States are considered non-profit. The definition of a non-profit hospital is that its purpose is to serve the healthcare needs of the community. The reason that non-profit hospitals and other organizations were established was with the intention of servicing the needs of all communities. Over time there missions and values changed to have a primary focus on the indigent population. Most are/were well rooted in religion or were created by religious sponsors while others were formed by the humanitarians, nurses, and doctors. One of the distinct differences between non-profit and for-profit hospitals is the rules and regulations, particularly tax status. Non-profit hospitals are not required to pay property, sales, or income tax. It has been suggested that due to the fact the organizations were providing specific social services to the community, they were to be exempt from paying certain taxes. As of April 2012, non-profit hospitals had to begin to abide by four new mandates: * Community Health Needs Assessment * Must have written financial assistance and emergency medical care policy and procedures * Necessary medical care and emergency services must be at the minimum charge/cost. * Be in compliance...
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...Reimbursement and Pay-for-Performance HCS/531 March 25, 2013 Reimbursement and Pay-for-Performance With health care reform taking full effect, various changes are emerging with regard to health care provider reimbursements. Third-party and government payers are rapidly moving toward pay-for-performance approaches that emphasize the quality rather than the quantity of health care services. Pay-for-performance initiatives have the capability of significantly impacting reimbursements based on whether or not and to what extent certain performance outcomes are met. At the same time, health care providers and consumers are both positively and negatively affected by pay-for-performance programs. While the future of pay-for-performance programs is unknown, it can be assumed that health care providers will likely carry increased pressures with regard to outcome responsibilities. With the continual addition of regulations set forth by the Centers for Medicare and Medicaid Services (CMS), demands to consistently provide high-quality care will increase. Pay-for-Performance Pay-for-performance is a payment model that rewards physicians, hospitals, medical groups, and other healthcare providers with financial incentives based on performance on select measures (Epstein, 2012). These performance measures can cover various aspects of health care delivery including: clinical quality and safety outcomes, efficiency, health care access and availability of care, patient experience and...
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