...Financial Managers and Quality Initiatives in Health Care Post University Tina M Dixons Abstract This paper will discuss the importance of why financial manager should be concerned with quality initiatives in the health care setting. The topic will describe why quality initiatives are a key role in the financial success and failures in healthcare. Delivery of healthcare is synonymous with finance and the task related to quality improvement and quality initiatives that support accuracy in documentation and treatment. There is a strong correlation between providers and finance. Key words: Finance, Quality initiatives, Providers, Patient care. Financial Managers and Quality Initiatives It is clear that if good quality of services, successful outcomes and customer satisfaction are presented in a healthcare setting, then the financial stability may sustain. As financial managers collaborate to achieve health care quality, they know that there are several variable factors that must manifest in order to sustain and earn profits for their organization. Some variables include reduction in medical error, appropriate diagnostics, medical analysis, education programs, staff training, prevention, primary care, financial reimbursements, technological advancements and minimizing waste. Error and Accuracy Medscape reported that “Eight years ago, the Institute of Medicine's (IOM) report To Err is Human revealed that between 44,000 and 98,000 Americans...
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...Baptist Health, headquartered in Louisville, Kentucky is the largest not-for-profit healthcare organization in the state. The vision of this HCO is to be nationally recognized as a healthcare leader in the state of Kentucky. Baptist Health was originally founded in 1924 as a single 120 bed hospital in Louisville, Kentucky. Expansions in 1953 with the addition of Western Baptist Hospital in Paducah, Kentucky and in 1954 with the addition of Central Baptist Hospital in Lexington, Kentucky created the foundation for the HCO known today as Baptist Health (Welcome to Baptist Health hospitals and clinics in Kentucky, 2013). Baptist Health has expanded on this foundation to become the largest HCO in the state with seven owned hospitals and two managed hospitals. Along with the hospital initiative, Baptist Health has begun to employ physicians, their practices and assets. By doing so, the HCO is positioning itself for increased competition in the Louisville market and across the state. This economic trend will take Baptist Health into the future and continue its vision to be nationally recognized as a healthcare leader in the state of Kentucky. With national health care reform driving the way that healthcare is delivered to patients, Baptist Health with its acquisitions of hospitals and physician practices the HCO will be able to meet the national regulations and still deliver quality patient care. At the end of the fiscal year 2011 Baptist Health employed 230 physicians...
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... | |Quality Improvement in Primary Care | | | | | | | | With the movement to advance quality care and the improvement of health care outcomes, organizations have increasingly implemented quality improvement (QI) initiatives to meet requirements. Quality Improvement refers to activities aimed at improving performance and is an approach to the continuous study and improvement of the processes of providing services to meet the needs of the individual and others. Engaging primary care practices in quality improvement activities is essential to achieving improvements in health care such as the triple aim. In an effort to create a high-value health care system the focus on improving the performance and safety of primary care is a must. The objective of this...
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...Comprehensive Primary Care Initiative Vanessa Clark HCA/210 Sunday, November 18, 2012 Dr. Dawn Tesner The Comprehensive Primary Care Initiative is a multi-payer initiative fostering collaboration between public and private health care payers to strengthen primary care. Medicare will work with commercial and State health insurance plans and offer bonus payments to primary care doctors who better coordinate care for their patients. Primary care practices that choose to participate in this initiative will be given resources to better coordinate primary care for their Medicare patients. The Comprehensive Primary Care Initiative (CPC or CPCI) will benefit patients as well the health care field. The CPCI will increase payments from Medicare and about 45 private insurers to primary care physicians and practices that: provide higher quality, easily accessible care; engage patients and caregivers as they transform their practices; emphasize prevention and management of chronic and complex conditions; assure better communication across practitioners and effective use of health information technology; and ensure smooth transitions of care for their patients across settings such as hospitals to home. This initiative will promote patient engagement and use the feedback from patients and family caregivers to help assess how effectively primary care practices are transforming themselves. This will give patients and caregivers a voice and encourage real partnership between patients...
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...Reliance Industries Limited CSR Initiative Analysis About Reliance Reliance Industries Limited (RIL) is India's largest private sector enterprise with businesses across the energy and materials value chain and a strong presence in the rapidly expanding retail, telecommunications and media sectors. RIL's diverse projects and operations touch lives of people in many ways and create value by helping in overall and holistic development of communities across multiple geographies. Through its various initiatives, the group endeavours to play a relevant role by serving communities and projects that address gaps in basic societal requirements. Reliance’s Philosophy RIL seeks to continue its contribution to the society through its distinct value proposition that meets the needs of millions of people, enhancing their lives through healthcare, improving quality of living by providing education and enabling livelihoods by creating employment opportunities-through the following: a) For the Business- value created for the society through business (including employment generation, market growth, creating opportunities etc.) b) By the Business- value created through CSR initiatives across different operatingfacilitieswithappropriatelinkagestolocalcommunitiesinwhichtheyoperate. c) Beyond Business- value created through interventions for the communities in diverse geographies across India. The key philosophy of all CSR initiatives of RIL is guided by three core commitments...
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...Health care Ecosystems Kaiser Permanente is known as the largest integrated managed care organization which is based out of Oakland, California. Kaiser Permanent was founded in 1945 by industrialist Henry J. Kaiser and a physician by the name of Sidney Garfield. Kaiser’s Mission Statement is “to provide affordable high-quality healthcare services and improve the health of our members and the communities we share.” Kaiser’s Vision/Value Statement” is to be a leader in total health by making lives better.” Kaiser Permanente prides itself with community involvement and support throughout their regions. Kaiser Permanente supports a diverse selection of organizations that work to improve the health of the area residents and the surrounding communities. Kaiser Permanente also funds events that support business, economic vitality and community growth and development. The diverse involvement impacts the growth of the organization by marketing themselves to being a “leader in total health”. In visiting the many Kaiser medical groups or hospitals you can’t help but run into the farmer’s market which promotes fresh fruits and vegetables for the community to purchase. The cooking demonstrations of healthy eating is a social as well as an economic event open to the patient’s, employee’s and the community. With our focus on childhood obesity within our nation, Kaiser Permanente helps promote a healthy lifestyle to all walks of life. Social responsibility and community involvement validates...
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...the connection between Health, Care and Value. We help to improve the health of our communities, deliver better care to members, and provide greater value to our customers and shareholders. WellPoint is the nation’s largest health benefits company, with more than 33 million members in its affiliated health plans. As an independent licensee of the Blue Cross and Blue Shield Association, WellPoint serves members as the Blue Cross licensee for California; the Blue Cross and Blue Shield licensee for Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, New York (as the Blue Cross Blue Shield licensee in 10 New York City metropolitan and surrounding counties and as the Blue Cross or Blue Cross Blue Shield licensee in selected upstate counties only), Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), and Wisconsin. In a majority of these service areas, WellPoint does business as Anthem Blue Cross, Anthem Blue Cross Blue Shield or Empire Blue Cross Blue Shield (in the New York service areas). WellPoint also serves customers throughout the country as UniCare. www.wellpoint.com Mission, Vision & Values What Makes Us WellPoint With an unyielding commitment to meeting the needs of our diverse customers, we are guided by the following principles: Our Mission WellPoint's mission is to improve the lives of the people we serve and the health of our communities. ...
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... (La Tour, 2013). Clinical Quality Medical professional should select quality measures for reporting such as commonly treated conditions, the types of care that are frequently delivered, the settings in which care is given, quality improvement goals and other quality reporting options that are available or being considered. A couple of options available are Physician Quality Reporting System and Value Based Purchasing. Both programs are based on quality of care rather than the amount of services they may provide. (CMS, 2014) Reimbursement for Healthcare Services Currently Medicare’s reimbursement for service is by the Prospective Payment System. This system is based on a fixed amount for the service provided and also based on the classification of where the service was provided as well. For example, Medicare will provide payment for both the operating and capital-related costs of the acute care hospital as well as the long-term care hospitals. (CMS, 2014). Patient Access to Care When everyone works together to coordinate the patient care, the patient receives better quality care and everyone will see a decrease in costs. Here are just a few options available that could help patients with access to care. Partnership for Patients hopefully will help to reduce the amount of hospital-acquired conditions and help improve the transitions in the care received. Bundled Payments for Care Improvement will seek to improve the patient care by allowing more flexibility in...
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...Running head: COST AND QUALITY ANALYSIS Healthcare cost and quality Grand Canyon University July 24th, 2012 Ethics, Policy, and Finance in the Health Care System Sally L. Clark A challenge that the healthcare nation is facing is to provide the quality of care that is expected and obtain low healthcare cost. Working hand in hand with the private sector and government is in hopes of improving the quality of care that each patient deserves and maintaining the cost so that research can continue. The purpose of this paper is to look into relationships between healthcare cost and quality healthcare. Differences in HealthCare Cost and Quality Working in the healthcare system, you often wonder if the nation works on quality of care or do they work more on cost of healthcare. Quality of care is an important role in achieving the best healthcare. Cost of healthcare is based on incentives that support the effectiveness while curving the spending growth (MacReady, 2012). Reform needs to be provided a baseline in evaluating healthcare delivery systems for a broader success of payments and delivery models with payment providers (2012, p.2). Sometimes higher cost effects quality of care. Some decisions need to be made that may affect the “clinical and fiscal health of the nation” (2012 p.1). Differentiating Roles and Major Activities Public and Private agencies plays an important role on how healthcare is delivered. The Commonwealth Fund...
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...Soderberg-Beck University of Phoenix Author Note: This paper is being submitted on January 30, 2015, for Dr. Kale Kruger’s HCS/514 Managing in Today’s Health Care Organizations course. Merger Memo MEMORANDUM TO: All Employees FROM: Management Team DATE: January 30, 2015 SUBJECT: Healthcare International Organization Merger CC: Leadership Team In response to the recent merging of Healthcare International and Care Alliance Health Systems, the management teams of both medical facilities has come together to write a memo on the merger and the effect that it will have within our new organization. Our organization will now be called Care Alliance International Systems. This memo will discuss how the merger will affect our organizational culture (on products and services), how organizational behavior affects overall quality, and how organizational behavior affects competition and human relations. In addition to that, this memo will review how job design, work processes, and performance expectations effect our organization. Lastly, this memo will discuss how the management team will ensure the success of the new Care Alliance International systems. Organizational Culture: Care Alliance Health Systems is dedicated to providing a healthy culture within our facilities so that we may maintain our spirit of excellence with our customer service. There are several impacts...
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...government established an agency that prompted a series of health care related initiatives in Australia. The main objective is to provide support to the patients, health care worker and, and health care stakeholders. It is called the Australian Commission on Safety and Quality in Health Care. The government provided the funding for the office to create initiatives in regards to safety in healthcare and improvement in the quality of healthcare in Australia. According to the article written by Sophie Scott, the Productivity Commission reported an increase in serious medical errors made in hospitals in Australia from 87-107 cases. However, despite of the report there is a decrease of serious adverse events from 2007-2012. There...
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...factor in health care delivery. The way health care is financed impacts it’s delivery. The continual increase of health care cost caused health care reform initiatives to control cost to focus on reimbursement models. Pay For Performance (P4P) is an increasingly popular initiative. The use of pay for performance has effects on the cost, quality, and efficiency of health care. This paper will discuss the effects the use of pay for performance has on patients, provider, and the evolution of health care delivery. Pay for Performance Pay for Performance plans were developed in the early 2000’s as a way to control costs. “Pay-for-Performance is a reimbursement plan that links payment to quality and efficiency as an incentive to improve the quality of health care and to reduce costs” (Shi & Singh, 2012, p. 586). Pay for performance is based on the belief that payment incentives will drive providers to deliver better care which will lead to disease prevention or early diagnosis. Pay for performance incentives give providers bonuses for meeting pre determined quality measures. The main quality measures used in P4P are patient experience, process, outcomes, and structure. Defining Pay for Performance Measures Patient experience refers to patients' assessment and satisfaction with the quality of care received, for example, wait time, communication and cleanliness of provider’s office. Process measures assess the performance of activities that contribute to positive health outcomes...
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...reductions impact the quality and efficiency of healthcare. I will discuss how Pay-for- Performance, effects healthcare providers and their customers. I will discuss the effects of Pay-for- Performance and the effect it will have on the future of healthcare. First we must understand what reimbursement and pay performance is. Pay-for-performance is referred to as an umbrella term with performance initiatives that are designed to improve efficiency, quality of the health care system. Pay-for-performance is a reimbursement plan that links payment to quality and effectiveness as an initiative to improve the quality of healthcare and reduce costs. Reimbursement is what the insurance company will pay to the provider and the reimbursement may be only a partial amount of what the actual charges. (Health Affairs, 2012) How is reimbursement affected by the pay for performance approach? This reimbursement method is a where some providers and hospitals pay better than other healthcare facilities for the same service. Their patients appear to have better health outcome results. The two main objectives are; (1) To increase the overall quality of health care that a patient receives. (2) To encourage behavioral changes on the part of providers and hospitals that lead to increased efficiency (Mayes, 2006). With new initiatives in the pay for performance in healthcare, a domain structure of payments already generates initiatives of its own. A large majority of the initiatives within the United...
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...factor in health care delivery. The way health care is financed impacts it’s delivery. The continual increase of health care cost caused health care reform initiatives to control cost to focus on reimbursement models. Pay For Performance (P4P) is an increasingly popular initiative. The use of pay for performance has effects on the cost, quality, and efficiency of health care. This paper will discuss the effects the use of pay for performance has on patients, provider, and the evolution of health care delivery. Pay for Performance Pay for Performance plans were developed in the early 2000’s as a way to control costs. “Pay-for-Performance is a reimbursement plan that links payment to quality and efficiency as an incentive to improve the quality of health care and to reduce costs” (Shi & Singh, 2012, p. 586). Pay for performance is based on the belief that payment incentives will drive providers to deliver better care which will lead to disease prevention or early diagnosis. Pay for performance incentives give providers bonuses for meeting pre determined quality measures. The main quality measures used in P4P are patient experience, process, outcomes, and structure. Defining Pay for Performance Measures Patient experience refers to patients' assessment and satisfaction with the quality of care received, for example, wait time, communication and cleanliness of provider’s office. Process measures assess the performance of activities that contribute to positive health outcomes...
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...creation, community service, quality improvement initiatives, health informatics, and health care technology. Group Practice Creation Impacts Mayo Clinic's Growth Dr. William J. Mayo justified the concept of a group practice in a speech he delivered in 1910. He took the view that it would be foolish for a single practitioner to assume he or she had sufficient knowledge of medicine. He maintained that it is in the best interest of the patient to have practitioners join forces and coordinate care (Mayo Foundation for Medical Education and Research [MFMER], n.d.-a.) Patients realized the benefits of a team of medical experts, so patients travelled long distances for diagnosis and treatment. The Mayo Clinic website states that the "group practice concept that the Mayo family originated has influenced the structure and function of medical practice throughout the world" (MFMER, n.d.-b). According to the website, the Mayo Clinic has grown from three physicians (father and two sons) to over 55,000 staff at locations in the Midwest, Arizona, and Florida. The Mayo Clinic is most famous for its implementation of an "integrated, multi-specialty, group practice" (MFMER, n.d.-c). Mayo Clinic Community Service Reflects Mission and Values According to the Mayo Foundation for Medical Education and Research (n.d.), Mayo Clinic's mission is to "provide the best care to every patient through integrated clinical practice, education and research." The Mayo Clinic's values involve positive and forward...
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