...Table of Contents Introduction Page 3 Risk Scenario Related to Patient Care and Safety Page 5 Risk Scenario Related to the Physical Plant Page 9 Risk Scenario Related to Staffing Page 13 Best Practices in 4 Hospitals Page 15 Tenet Healthcare Page 16 Cleveland Clinic Stroke Improvement Plan Page 17 Conclusion Page 18 References Page 19 Introduction The issue of risk scenario carries immense importance for most of the hospitals that are part of the healthcare setting. However, there is not only one scenario that can affect the hospitals but there are several scenarios that can create an impact on the functions of the hospital. There are three scenarios that would be highlighted in the current topic. These three scenarios have a tendency to put a hospital at risk for financial stability. The first scenario that can produce a negative impact on the hospital risk is related to patient care and safety. The second scenario is related to the physical plant. The third and last scenario is related to staffing. The role of HIM practitioner in this regard would be very important. They would serve as a clinical quality assessment resource and as a team member to perform their tasks related to healthcare work. Therefore, all the issues related to three scenarios will be discussed in detail. The impetus for quality improvement has been driven in recent years by three main factors: 1. The amount of money that the US spends on healthcare per capita and as...
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...HOSPITALS Uncompensated Care and Other Community Benefits Statement of David M. Walker Comptroller General of the United States GAO-05-743T May 26, 2005 Highlights Highlights of GAO-05-743T, a testimony before the Committee on Ways and Means, House of Representatives Accountability Integrity Reliability NONPROFIT, FOR-PROFIT, AND GOVERNMENT HOSPITALS Uncompensated Care and Other Community Benefits Why GAO Did This Study Before 1969, IRS required hospitals to provide charity care to qualify for tax-exempt status. Since then, however, IRS has not specifically required such care, as long as the hospital provides benefits to the community in other ways. Seeking a better understanding of the benefits provided by nonprofit hospitals, this Committee requested that GAO examine whether nonprofit hospitals provide levels of uncompensated care and other community benefits that are different from other hospitals. This statement focuses on, by ownership group, hospitals’ (1) provision of uncompensated care, which consists of charity care and bad debt, and (2) reporting of other community benefits. The hospital ownership groups were (nonfederal) government, nonprofit, and for-profit. To compare the three hospital ownership groups, GAO obtained 2003 data from five geographically diverse states with substantial representation of the three ownership groups in each state. GAO analyzed cost data from two perspectives—each hospital group’s percentage of (1) total uncompensated care...
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...Medicaid, the State Children’s Health Insurance Program (SCHIP) and Accessing Community Care through Eastside Social Services (ACCESS). These programs enable eligible low-income individuals and their families to seek medical assistance reducing uncompensated care and hospital costs. The primary source of funding for uncompensated care is government dollars. The government collects taxes to fund various public services. American taxpayers have every right and should be concern about how the money is being spent. Controlling tax expenditures poses a major concern especially when considering reducing deficit as well as reducing taxes for Americans. The federal government is by far the largest funder of uncompensated care. In 2013, the federal government provided $32.8 billion (61.5 percent) to help providers cover costs associated with caring for the uninsured. State and localities are the second largest, providing another $19.8 billion; the private sector is estimated to contribute $0.7 billion (Caswell, Coughlin, Holahan, & McGrath, 2014). Medicare, Medicaid, SCHIP, and Affordable Care Act marketplace subsidies together accounted for 24 percent of the federal budget in 2014, or $836 billion. Nearly two-thirds of this amount, or $511 billion, went to Medicare. The remainder of this category funds Medicaid and CHIP, which typically on a monthly basis provide health care or long-term care to about 70 million low-income...
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...Economics of an Urgent Care Center in a Market of Emergency Departments One of the contributors to the rising cost of Healthcare can be attributed to the over use of emergency departments (EDs) for non-emergency needs. In the greater Capitol/First/Beacon Hill area there are three major hospitals (Virginia Mason, Harborview, and Swedish) with emergency rooms and no urgent care centers with the exception of Group Health which is restricted to Group Health insurance members. The question I asked myself is, “Why does Group Health have urgent care for their insurance plan members and the major hospitals in Seattle do not.” Urgent vs. Emergency Care A study by the CDC showed that approximately 70 % of emergency department visits can be treated in a typical primary care or urgent care setting and another study by National Center for Policy Analysis demonstrated that only 13% of patients that sought treatment in the emergency department were clinically appropriate. Reasons for non-emergency visits to the ED range from access issues to primary care providers (wait times, no primary care provider assigned, or no insurance) to a lack of knowledge that they could have been treated at an urgent care or primary care setting. There are good reasons to visit the emergency department: * Trauma due to an accident or assault | * A wound that will not stop bleeding | * Shortness of breath | * Vomiting blood | * Chest pain | * Sudden loss of consciousness...
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...Question #1 Describe how you would assess the impact of the health care issue you selected in microeconomic terms. The health care issue I have chosen is the uninsured Americans and the cost effect on the Unites States government. The issue of uninsured Americans has been one issue that keeps coming up from time to time because a large number of the society are losing their medical insurance due to loss of employments and pre-existing conditions that most insurance company don’t accept. Government and the hospital emergency rooms where those that are uninsured end up going are at the losing end on whole situation. I will try and use Cost Benefit Analysis to evaluate the cost of the uninsured on the Government purse. Cost benefit analysis is an important economical tool that can be used in the healthcare industry because it helps in determining what the outcome of a project would be. It looks at both the positive and the negative aspect of the program. It will also show the cost and consequence of being uninsured. According to Jack Hadley, the Principal Research Associate at The Urban Institute, uninsured Americans have cost the Federal government in the three following ways: The Government already spends a substantial amount of money on care to the uninsured According to (Jack Hadley, 2003) it is estimated that in 2001 that the nation spent about $35 billion on uncompensated care received by uninsured, both those who are uninsured for a full...
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...Affordable Care Act beginning in 2014. Nationwide, only 2 percent of acute-care hospitals are safety-net facilities, but they currently provide about 20 percent of all uncompensated care to provided to the uninsured. Despite this statistic, a decline in America's uninsured is unlikely to relinquish the need for safety-net hospitals, according to experts. Public hospitals for the poor will still have a place in the American landscape, especially since most safety-nets are responsible for training physicians and take on significant patient volumes would otherwise incapacitate markets. Instead, it's the traditional role and public perception of safety-nets that's poised for the biggest transformation. "These hospitals don't always set out wanting to be the safety-nets, but it's a position they get forced into," says Igor Belokrinitsky, a strategy consultant with Booz & Company in Chicago. "They become a hospital of last resort, but they really want to be a hospital of choice. Do you want to stay a safety-net hospital or find something else that will set you apart?" One safey-net's approach Newspaper editor Henry W. Grady founded Atlanta-based Grady Health more than 120 years ago, concerned about a lack of quality healthcare for Atlanta's poor. Today, Grady's payer mix is roughly 34 percent uninsured, 32 percent Medicaid and 17 percent Medicare, with the rest covered by commercial insurance and workers' compensation. Grady provided roughly $200 million in uncompensated care...
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...Immigration and Healthcare Cost Angela Mporampora Metropolitan State College of Denver Healthcare Finance HCM 4030 Professor kelvin D. Zeller March 25, 2012 Immigration and healthcare cost Abstract. The rise in healthcare cost has been one of the most troubling economic events in recent years. Healthcare cost rises about 7.5 percent every year. The United States is known to be the nation with the highest amount spent on healthcare. Some research links immigrants to the fast paste in healthcare cost increase. Immigration became a top issue after the event of September 11th. Many believes immigration is the root cause of most of the economic problems taking place in the country today, they linked immigration to increase in healthcare cost, increase in crime rate, reason for low productivity, reason for loss of job opportunity for native- born and many more. But on the other hand, are these groups of individuals who believe immigrants are being used as “scapegoats” just because they don’t have a voice or stand in the society. They stressed the believe that even before immigration became a hot topic, the economy already had this problem in place, they denoted most research findings stating data were manipulated to support their mission; for immigrant do not visit medical establishment as often as indigenes and wonder how researchers came to the conclusion that immigrants spiked up healthcare cost. This subject is distinctly two sides and it’s difficult to find...
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...1. Point-Counterpoint State Medicaid Policy and Health Reform Harold A. Pollack University of Chicago Authors: Pollack, Harold A.1 Source: Journal of Health Politics, Policy & Law; Feb2013, Vol. 38 Issue 1, p161-163, 3p The article discusses the positive and negative implications of the new ruling that the federal government could not require states that receive federal funds under the Medicaid program to participate in the Patient Protection and Affordable Care Act's (PPACA's) Medicaid expansion. Several shortcomings like limited provider payment and associated patient access barriers have been observed in Medicaid that make its adoption not a good idea. However, families below the poverty line can benefit. In July 2012, the Supreme Court upheld the constitutionality of the Patient Protection and Affordable Care Act (PPACA). The Court thus ended one phase in the political and legal battle over health reform. Yet in doing so, it opened a new front. In a notable departure from post–New Deal commerce clause jurisprudence, the Court ruled that the federal government could not require states that receive federal funds under the Medicaid program to participate in the PPACA’s Medicaid expansion. In effect, the Court made states’ participation in the PPACA’s Medicaid expansion voluntary — a possibility that neither the act’s supporters nor its opponents seriously entertained during the long legislative battle of 2009 and 2010. The full implications of these...
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...ACID-BASE DISORDERS MADE SO EASY EVEN A CAVEMAN CAN DO IT Lorraine R Franzi, MS/HSM, RD, LDN, CNSD Nutrition Support Specialist University of Pittsburgh Medical Center Pittsburgh, PA I. LEARNING OBJECTIVES The clinician after participating in the roundtable will be able to: 1) Indicate whether the pH level indicates acidosis or alkalosis. 2) State whether the cause of the pH imbalance is respiratory or metabolic. 3) Identify if there is any compensation for the acid-base imbalance. II. INTRODUCTION Acid-Base balance is an intricate concept which requires an intimate and detailed knowledge of the body’s metabolic pathways used to eliminate the H+ ion. Clinicians may find it daunting to understand when first introduced to the subject. This roundtable session will demonstrate how to analyze blood gas levels in a very elementary manner so as to diagnose any acid-base disorder in a matter of minutes. The body is in a constant state of flux delicately stabilizing the pH so as to maintain its normalcy. In order to prevent untoward effects of alkalosis or acidosis the body has three major buffering systems that it uses to adjust the pH. They are: 1) Plasma protein (Prot-) 2) Plasma hemoglobin (Hb-) 3) Bicarbonate (HCO3-) The Bicarbonate-Carbonic acid system is the most dominate buffering system and controls the majority of the hydrogen ion (H+) equilibrium. Maintaining homeostasis when these acid-base shifts occur is vital to survival. Metabolic and respiratory...
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...Termination of Illegal Immigrants With the reputation as a national melting pot, America is known for its vast diversity in several aspects: ethnic, religious, and lingual diversity. Since America’s independence, millions of people have immigrated to this country seeking a better opportunity: education, freedom, quality of life and work. The Department of Homeland Security reports that in 2011 there were a total of 1,062,040 new legal permanent residents in the United States (Monger and Yankay). Whereas there are more than ten times that amount of illegal immigrants living in the US, estimated to be 11.5 million … with 35,000 illegal immigrants residing in Washington, D.C (Hoefer, Rytina, and Baker: Dane). Noel Merino defines ‘Illegal Immigrants’ as people who enter the United States unlawfully, or may be admitted on a temporary basis and stay past the date they are required to leave (14). Since America is a land of dreams and opportunity, thousands of people have taken the risk to come here and work without legal documentation which has led to various social problems. Illegal workers taking jobs from legal immigrants, the state and federal government losing tax revenue, unfair use of social benefits, fraudulent documents are counterfeited, and countless employers taking advantage of undocumented employees are all problems caused by illegal immigrants and could be fixed by lawful deportation back to their homeland. The main reason individuals enter the United States unlawfully...
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...Grandcanyon university | Health Care Access Paper | Professor Barri Mallin | | Sheila Ford | 12/16/2012 | | The purpose of this paper is to inform you of a proposal that the Governor of Texas has proposed to the state, on how he feel about the health care reform. I will be talking about how the governor thinks by” issuing top-down mandates on a break-neck timetable is a surefire way to make things worse”. The health care reform legislation currently being considered not only poses a serious threat to patients and providers, but will also cost Texas taxpayers tens of billions of dollars. I will be explaining how the governor feels that President Obama’s plan will cause harm to the health care system,” by increasing taxes and escalate medical price inflation and add more than $285 billion to the deficit over the next 10 years”. “Gov. Perry: Federal Health Care Proposals to Cost Texans Tens of Billions of Dollars Tuesday, August 18, 2009 • Austin, Texas • Press Release Share” “Gov. Rick Perry today emphasized the importance of state developed health care reform rather than the costly, expansive, one-size-fits-all mandates being considered by the federal government. The governor spoke at a press conference announcing the results of a study about federal health care proposals conducted by the Texas Public Policy Foundation (TPPF)”. “It’s clear Washington has no interest in allowing states to develop their own tailored solutions to problems that affect...
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...private and public problems of money due to uncompensated industrial accidents. D. Eliminate time consuming trials and appeals in the court. E. Eliminate attorney fees involved. F. accident caused is promoted by frank study and reducing accidents, human sufferings etc. G. Employer must abide the compulsory law that accepts and provides the benefits to workers. 2. Explain how you believe Workers Compensation program has helped workers. Though workers compensation insurance is costly for companies, there are some benefits from managing one’s workers compensation program. Explain. --Workers compensation is the insurance since 1900’s in the United States. From the beginning of 19th century as the growth of industries increased and the workers for the industries also increased, so the injuries’ had become more common in the factories where the workers used to deal with the larger machines and were working in hazardous conditions,. so a system was needed to compensate the workers who had suffered from injuries during working hours,. 1> Workers Compensation program has helped workers in relieving there mental stress. 2> This program has made the workers to claim the financial and medical expenses easy so that they don’t have to wait for years to get their compensation,. 3> In older days employers did not care much about workers injuries that are caused during working,. They used different lawsuits if any worker sue them in case,..so after introducing the workers compensation...
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...developed strong brand equity in the United States due to its high level of brand awareness. Nike’s sources of brand equity in the US include; Brand Image, Price, Packaging, Brand Awareness and Positioning. These sources of brand equity have created unique, durable, and efficient products that are recognized worldwide leading to higher volume sales and higher profit margins against competing brands. Nike’s effort to become a global corporation has affected its sources of brand equity and brand image in the United States, Europe, and Asia positively. They achieved this by establishing their name in popular sports like soccer, track and field and tennis in Europe, basketball in America and cricket in Asia. According to the book, Best Practice Cases in Branding: Lessons from the World’s strongest brands, the author states that, “Given the company’s track and field heritage, Nike initially focused on developing links in track and field, whose sizable popularity in Europe was reflected by the fact that it was the second most televised sport (after soccer).” Sponsorships and...
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...estimated that the annual costs of illegal immigration at the federal, state and local level to be nearly $113 billion dollars, with approximately $84 billion dollars being spent on the state and local levels alone. Recent studies have also estimates that taxes collected from illegal alien workers, both in the above-ground economy and in the underground economy do not come close to the amount of current expenditures. The impact of illegal immigrants on the federal budget differs from their effect on state and local budgets primarily because of the types of services provided by each level of government. The federal government while providing some services requires state and local governments to provide certain services to individuals regardless of their immigration status or ability to pay in order for them to participate in federal programs. This has made most states and local governments bear much of the burden to providing education, health care and law enforcement to individuals living in their jurisdiction. Budgetary Effect of Illegal Immigration The Congressional Budget Office has attempted to evaluate for the last 15 years the impact of illegal immigrants on the budgets of state and local governments. The scope and analytical methods of the study vary and no reports have provided a consistent or reliable assessment of the national effect that illegal immigrants have on state and local budgets. The CBO was able to conclude through the reports hat state...
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...cannot agree on how this system should be fixed. On April 23, 2010, the Governor of Arizona, Jan Brewer, decided that she would attempt a solution to the problem. She signed into law one of the nation’s toughest bills focused on illegal immigration in her state. This law re-ignited the immigration debate all across the United States and brought out many protestors from both sides. Some of the issues at hand are amnesty, healthcare costs, and the increasing crime that illegal immigrants bring into our country. To begin with, does amnesty encourage illegal immigration? Secondly, what does it do to our already fragile health care system? Thirdly, what kinds of crimes are being committed by some illegal immigrants? In my opinion we need to do whatever we can to secure our borders and only allow those who come in legally into our country. Amnesty, in the case of illegal immigrants, is to grant legal status to those who have entered our country illegally. It forgives the fact that they have entered the country illegally, and forgives other illegal acts such as driving and working using false documents. In 1986 under President Ronald Reagan, our country granted what was supposed to be a “one time only” amnesty for approximately 2.7 million illegal aliens. At that time, Congress also enacted a new set of laws that were aimed at eradicating illegal immigration. What were the results of those new laws? We are no longer a nation that has 2.7 illegal aliens, but we are now home to...
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