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Pinnacle Health’s Regulatory
Process with the Joining of
UPMC
Presented by
Jillian Marinelli
Learning Objectives
 Looking at the Regulatory Process
 Benefit of knowing about this process
 The thought process behind new policy creation
 Personal experience
 Real world examples
Regulatory Process Snapshot
• Definition: The purpose of healthcare policy and procedures is to
provide standardization in daily activities such as health and safety,
legal liabilities and regulatory requirements.
• Where/when is this used?
– This is being used in the joining of both hospitals to formulate new
policies. This is done within a small office in the hospital and then
taken to the Board for further discussion
• Who commonly needs/uses this?
– This is needed when formulating federal laws, regulations, and
policies from the government, public, and hospital aspect
What is the benefit of knowing this?
• Why should someone be interested in this and why is this
important to know?
– This could one day be one of our careers!
• How can your instruction help them in the real world?:
– ”We try to develop powerful solutions, to help manage
policies and other documents in order to improve the
productivity and efficiency of the healthcare facility, as
well as, ensure it is not breaching any regulations”
New Policies & Regulations
• 5 Steps to guide a policymaker
– Examine the public health interest
– Examine the overall effectiveness of the policy
– Evaluate whether the policy is well-targeted
– Identify the human rights burden
– Examine whether the policy is the least restrictive alternative
• Time consuming and difficult
• Stephanie Okum: Director Customer Relations and Regulatory
at Pinnacle Health
– Deals with Health Policy implementation and correction in
the hospital
– She’s in charge of going through each of Pinnacle’s policies
in all departments and then compare them to UPMC in
regards to how they are operating in correlation to theirs
– She has a massive book kept in her office that serves as the
“guide” to regulations and rules that must be followed
within the hospital
Real-World Example #1
• Article goes over the
positives of merging
Pinnacle & UPMC.
• “Both transactions will
be subject to regulatory
approvals”
• This is where Stephanie
is coming into play with
the regulatory approval
process
Real-World Example #2
• “The UPMC Pinnacle Board
will handle Central
Pennsylvania operations,
including quality of care,
access to care, insurance
contracts, medical staff
development and growth
initiatives, according to
press release.”
• “We are pleased that the
affiliation is complete, and
we look forward to starting
a new chapter of
collaboration with UPMC”
BRING IT BACK AND RECAP
 Looking at the Regulatory Process
 Benefit of knowing about this process
 The thought process behind new policy creation
 Personal experience
 Real world examples
• For more information, contact me via
LinkedIn:
• Jillian Marinelli
• https://www.linkedin.com/in/jillian-marinelli-
423b29114/
Sources
• http://triblive.com/news/healthnow/inaheartbeat/12686047-
74/upmc-merges-with-pinnaclehealth-in-harrisburg
• https://www.nap.edu/read/4771/chapter/17
• https://www.policymedical.com/importance-healthcare-
policy-and-procedures/

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Teach-A-Topic HPA 433

  • 1. Pinnacle Health’s Regulatory Process with the Joining of UPMC Presented by Jillian Marinelli
  • 2. Learning Objectives  Looking at the Regulatory Process  Benefit of knowing about this process  The thought process behind new policy creation  Personal experience  Real world examples
  • 3. Regulatory Process Snapshot • Definition: The purpose of healthcare policy and procedures is to provide standardization in daily activities such as health and safety, legal liabilities and regulatory requirements. • Where/when is this used? – This is being used in the joining of both hospitals to formulate new policies. This is done within a small office in the hospital and then taken to the Board for further discussion • Who commonly needs/uses this? – This is needed when formulating federal laws, regulations, and policies from the government, public, and hospital aspect
  • 4. What is the benefit of knowing this? • Why should someone be interested in this and why is this important to know? – This could one day be one of our careers! • How can your instruction help them in the real world?: – ”We try to develop powerful solutions, to help manage policies and other documents in order to improve the productivity and efficiency of the healthcare facility, as well as, ensure it is not breaching any regulations”
  • 5. New Policies & Regulations • 5 Steps to guide a policymaker – Examine the public health interest – Examine the overall effectiveness of the policy – Evaluate whether the policy is well-targeted – Identify the human rights burden – Examine whether the policy is the least restrictive alternative • Time consuming and difficult
  • 6. • Stephanie Okum: Director Customer Relations and Regulatory at Pinnacle Health – Deals with Health Policy implementation and correction in the hospital – She’s in charge of going through each of Pinnacle’s policies in all departments and then compare them to UPMC in regards to how they are operating in correlation to theirs – She has a massive book kept in her office that serves as the “guide” to regulations and rules that must be followed within the hospital
  • 7. Real-World Example #1 • Article goes over the positives of merging Pinnacle & UPMC. • “Both transactions will be subject to regulatory approvals” • This is where Stephanie is coming into play with the regulatory approval process
  • 8. Real-World Example #2 • “The UPMC Pinnacle Board will handle Central Pennsylvania operations, including quality of care, access to care, insurance contracts, medical staff development and growth initiatives, according to press release.” • “We are pleased that the affiliation is complete, and we look forward to starting a new chapter of collaboration with UPMC”
  • 9. BRING IT BACK AND RECAP  Looking at the Regulatory Process  Benefit of knowing about this process  The thought process behind new policy creation  Personal experience  Real world examples
  • 10. • For more information, contact me via LinkedIn: • Jillian Marinelli • https://www.linkedin.com/in/jillian-marinelli- 423b29114/

Editor's Notes

  1. Our major pertains to the policy aspect. One day we could be working in a hospital that could merge with a neighboring hospital and the policies will need to be modified or combined, this is where we could come into play.
  2. 1. Policymaker should clearly and narrowly define the health purposes of the policy 2. an assessment of whether the policy is an appropriate intervention to achieve the stated objectives and whether it is reasonably likely to lead to effective action 3. A decision maker should determine whether a policy is narrowly tailored to address the specific health problem, or whether it is over- or under inclusive 4. This step requires an inquiry into the nature, invasiveness, scope, and duration of human rights violations. 5. Policymaker should assess whether the health objective could be achieved as well, or better, with fewer restrictions on human rights (consider alternatives that may accommodate individual interests)
  3. Finding news articles was really difficult for this process is still in the works and will take some time till it is all squared away Regulatory modifications need to be approved and reviewed by the Board before becoming finalized
  4. Recap just go over what was discussed in the simplest terms