Profit vs. Non-Profit Health Institutions
•Download as PPTX, PDF•
1 like•1,111 views
This document discusses the attributes, observations, trends, and key findings regarding for-profit (FP) and not-for-profit (NFP) health organizations. It finds that ownership status determines how profits are distributed and where hospitals locate, which influences their behavior and performance. Environmental and financial factors are causing some NFPs to become more commercial and potentially convert to FP status. The document concludes that while ownership affects certain outcomes, both FP and NFP hospitals can exist and make profits, but they distribute and use those profits differently according to their ownership model and mission.
Report
Share
Report
Share
![Agenda ,[object Object]](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)
Recommended
System Approach in Healthcare Management
1. A system is a collection of interconnected elements that work together towards a common goal. A healthcare system can be analyzed using a systems approach that views it as having inputs, processes, outputs, and feedback.
2. Applying a systems approach to healthcare involves analyzing it across four levels - the individual patient, care teams, healthcare organizations, and the broader political/economic environment. This allows understanding how each component interacts and influences outcomes.
3. Adopting a systems approach in Bangladesh's healthcare would help move it from the current disorganized model to one with better coordination and synergies between different entities, leading to improved quality of care.
Financial Management In Healthcare PowerPoint Presentation Slides
This document discusses various topics related to financial management in healthcare, including:
- Key financial trends in the healthcare industry such as value-based payments and data analytics.
- A comparison of healthcare expenditures as a percentage of GDP across different countries.
- An overview of different healthcare financing models.
- Metrics and analysis used for healthcare system financial analysis including profitability ratios.
- A comparison of hypothetical healthcare organization financial statements under two alternatives.
- Calculations of direct and indirect healthcare costs.
- Various statistics related to healthcare spending, quality, and the size of the global healthcare market.
Access to Health Care
The document discusses access to healthcare as defined by Healthy People 2020, including key determinants of health and implications of access such as quality of care and equitable delivery of services. It also outlines dimensions of access related to availability, accessibility, affordability, accommodation, and acceptability. Barriers to access and populations most affected are identified along with solutions provided by the Affordable Care Act.
What is a health system?
This document provides an overview of conceptual frameworks for understanding health systems. It defines a health system as all organizations, people and actions whose primary intent is to promote, restore or maintain health. It discusses several frameworks developed by the WHO and others to conceptualize the different components, actors and relationships within health systems. It acknowledges that health systems are complex and dynamic, with unpredictable paths of implementation for interventions. The document emphasizes that health systems should be viewed holistically as interconnected systems centered around people.
STRATEGIC PURCHASING
Strategic purchasing involves actively engaging in defining healthcare services, selecting providers, and payment methods to create quality incentives and control costs. This contrasts with passive purchasing which simply reimburses all bills. Strategic purchasing can help countries move toward universal health coverage by directing funds to priority populations and services through evidence-based incentives. The goal is to maximize health outcomes from available funding and expand access to care over time through a mutually reinforcing relationship between strategic purchasing and universal coverage.
5s-CQI-TQM For Hospital Quality Improvement
5s-CQI-TQM is the approach for improvement of healthcare delivery in a hospital setting, which is resource starved
Health care financing
This document discusses health care financing. It begins by defining key terms related to health care financing sources, including public expenditures, external aid, and private expenditures. It then outlines the main mechanisms of health care financing: general revenue, social insurance contributions, private insurance premiums, community financing, and direct out-of-pocket payments. For each mechanism, it provides a brief definition and description. The document concludes by stating that the role of health financing should be recognized, that it cannot be dealt with separately from other factors like governance and economic growth, and that governments need to actively participate to avoid market failures.
Healthcare systems
Healthcare is a major part of every country's development platform. By healthcare we are in fact protecting the most important driver of development. Healthcare systems are primarily safe guarding the development core engine and are the best means of sustainable development.
Recommended
System Approach in Healthcare Management
1. A system is a collection of interconnected elements that work together towards a common goal. A healthcare system can be analyzed using a systems approach that views it as having inputs, processes, outputs, and feedback.
2. Applying a systems approach to healthcare involves analyzing it across four levels - the individual patient, care teams, healthcare organizations, and the broader political/economic environment. This allows understanding how each component interacts and influences outcomes.
3. Adopting a systems approach in Bangladesh's healthcare would help move it from the current disorganized model to one with better coordination and synergies between different entities, leading to improved quality of care.
Financial Management In Healthcare PowerPoint Presentation Slides
This document discusses various topics related to financial management in healthcare, including:
- Key financial trends in the healthcare industry such as value-based payments and data analytics.
- A comparison of healthcare expenditures as a percentage of GDP across different countries.
- An overview of different healthcare financing models.
- Metrics and analysis used for healthcare system financial analysis including profitability ratios.
- A comparison of hypothetical healthcare organization financial statements under two alternatives.
- Calculations of direct and indirect healthcare costs.
- Various statistics related to healthcare spending, quality, and the size of the global healthcare market.
Access to Health Care
The document discusses access to healthcare as defined by Healthy People 2020, including key determinants of health and implications of access such as quality of care and equitable delivery of services. It also outlines dimensions of access related to availability, accessibility, affordability, accommodation, and acceptability. Barriers to access and populations most affected are identified along with solutions provided by the Affordable Care Act.
What is a health system?
This document provides an overview of conceptual frameworks for understanding health systems. It defines a health system as all organizations, people and actions whose primary intent is to promote, restore or maintain health. It discusses several frameworks developed by the WHO and others to conceptualize the different components, actors and relationships within health systems. It acknowledges that health systems are complex and dynamic, with unpredictable paths of implementation for interventions. The document emphasizes that health systems should be viewed holistically as interconnected systems centered around people.
STRATEGIC PURCHASING
Strategic purchasing involves actively engaging in defining healthcare services, selecting providers, and payment methods to create quality incentives and control costs. This contrasts with passive purchasing which simply reimburses all bills. Strategic purchasing can help countries move toward universal health coverage by directing funds to priority populations and services through evidence-based incentives. The goal is to maximize health outcomes from available funding and expand access to care over time through a mutually reinforcing relationship between strategic purchasing and universal coverage.
5s-CQI-TQM For Hospital Quality Improvement
5s-CQI-TQM is the approach for improvement of healthcare delivery in a hospital setting, which is resource starved
Health care financing
This document discusses health care financing. It begins by defining key terms related to health care financing sources, including public expenditures, external aid, and private expenditures. It then outlines the main mechanisms of health care financing: general revenue, social insurance contributions, private insurance premiums, community financing, and direct out-of-pocket payments. For each mechanism, it provides a brief definition and description. The document concludes by stating that the role of health financing should be recognized, that it cannot be dealt with separately from other factors like governance and economic growth, and that governments need to actively participate to avoid market failures.
Healthcare systems
Healthcare is a major part of every country's development platform. By healthcare we are in fact protecting the most important driver of development. Healthcare systems are primarily safe guarding the development core engine and are the best means of sustainable development.
Health care financing
The document summarizes healthcare financing in India. It discusses that healthcare financing aims to ensure access to health services. The key principles are generating revenue, pooling funds for cross-subsidization between rich/poor and healthy/sick, and purchasing efficient services. In India, healthcare is financed primarily through out-of-pocket payments by households, while government expenditure is low compared to other countries. Reforms like NRHM and RSBY aim to increase public allocation to healthcare. Challenges include expanding coverage with limited resources and improving spending efficiency.
Introduction to Health Systems & Health Services Systems
The document provides an overview of a course on health service systems and health systems. It discusses several topics that will be covered in the course, including major issues in organizing health services, assessing population health status, analyzing healthcare access and costs. The course will also examine sociopolitical, economic, and ethical issues facing public health systems. Students will learn about different components of health systems through mini-lectures, discussions, and by analyzing case studies.
Health Sector Reforms prersentation
The document discusses health sector reforms in India. It provides context on the need for reforms due to fiscal constraints and poor social indicators. Key reforms introduced include decentralization, increasing human resources, financial reforms, reorganizing the existing health system, improving health management information systems, increasing community involvement, and ensuring quality. National initiatives like the National Rural Health Mission aim to promote equity, efficiency, quality and accountability in primary healthcare. The overall goal of health sector reforms is to improve access to healthcare and ultimately population health outcomes.
What is a health system? What is health system strengthening?
What is a health system? What is health system strengthening?Collaboration for Health Policy & Systems Analysis in Africa (CHEPSAA)
The document defines a health system as consisting of all organizations, people, and actions whose primary purpose is to promote, restore, or maintain health. It discusses health systems as complex adaptive systems with many interacting elements. It presents several conceptual frameworks for analyzing health systems, including the WHO health system building blocks and the Antwerp health system dynamics framework. It then discusses the concept of health system strengthening and changing global approaches to improving health systems over time, moving from a disease-focused approach to a more holistic health system strengthening approach.Quality in Healthcare Organizations
This document discusses the fundamentals of quality improvement and introduces key concepts such as measuring quality of care, common quality issues in healthcare, and the role of health information technology in improving patient safety and care quality. It provides an overview of quality improvement initiatives in the US such as meaningful use and accountable care organizations that aim to enhance care through the use of health IT.
US health care system overview 1
The document summarizes the major characteristics of the US healthcare delivery system. It notes that the US system has no central governing agency and little integration between parts of the system. It is technology-driven, focuses on acute care, and is high in costs but unequal in access, resulting in average health outcomes. The US relies more on private sector involvement compared to other developed countries where government plays a larger role.
Health sector reforms- INDIA
HEALTH SECTOR REFORMS- INDIA
Slides contain;
Reforms & Health System
Definition- HSR
Introduction
Financial reforms
Structural re-organization
Communication
Quality Assurance
Convergence
Public Private Partnership
Ways forward for effective HSR
Conclusion and points for Consideration
End
Health system
The document discusses healthcare systems and financing in Bangladesh. It provides an overview of Bangladesh's healthcare system, which is led by the Ministry of Health and Family Welfare and delivers services through two branches - the Directorate General of Health Services and the Directorate General of Family Planning. Non-governmental organizations also play an important role in service delivery. The system includes various types of public health facilities at the national, divisional, district, upazila, union and ward levels. It also discusses urban health systems managed by city corporations, and describes the main organizations responsible for health financing in Bangladesh, including the Ministry of Health, social security organizations, and private health insurance funds.
Concept of efficiency,effectivenes,Role of health care financing
Efficiency refers to performing with minimum wasted effort or expense. It is measured by the ratio of useful output to total input. There are several types of efficiency including economic, market, operational, productive, and X efficiency. Equity means fairness and is concerned with equal access and treatment. Horizontal equity means equal treatment of equals while vertical equity means unequal treatment of unequals. Elasticity of demand refers to the responsiveness of quantity demanded to a change in price. Demand can be elastic, inelastic, perfectly inelastic, perfectly elastic, or unitary elastic. The roles of health care financing include mobilizing resources, setting incentives for providers, and ensuring access to care. Financing functions include revenue collection, risk pooling, and purchasing of
Universal Health Coverage (UHC) Day 12.12.14, Nepal
This presentation is made on the first ever Universal Health Coverage (UHC) Day 12.12.14 celebration in Nepal by Nepal Health Economics Association (NHEA).
Health care delivery system in usa
The US health system is complex, relying on government, private markets, and charities. It consists of private health insurance, government programs like Medicare and Medicaid, and a public health system. Major components include private physicians and hospitals, as well as health maintenance organizations. The system faces rising costs and led to the 2010 Affordable Care Act which expanded insurance coverage.
Health Financing Functions: Risk Pooling
Presentation by Dr. Elaine Baruwa, Abt Associates, at Haiti's International Conference on Access to Health Care for All in Haiti: Challenges and Perspectives for Funding, April 28-29, 2015, Haïti
Universal Health Coverage
Understanding the concept of Universal Health Coverage (UHC) and how can we reach it, both globally and also in India. The presentation also includes HLEG report , which is the proposed architecture for India's guide to reach UHC.
Hospital business plan sample
The document provides an executive summary for a business plan for Project E, which will be Botswana's first private psychiatric hospital. It outlines the company's goals of increasing beds and admissions over time. Financial projections show an investment need of $9 million with positive cash flow and returns expected. The management team is experienced in the mental healthcare field.
Health system functions and structure
A health system consists of all organizations, people and actions whose primary intent is to promote, restore or maintain health .
Healthcare financing
Tax-based systems finance healthcare through taxes collected from the entire population of taxpayers, allowing risks to be pooled across a large group. This subsidizes care for the poor and sick by transferring wealth from the rich and healthy. However, overuse of free services remains a problem. Pay-as-you-go user fee systems represent a market-based solution but fees disproportionately reduce access for the poor. Risk-based private insurance guarantees entitlement by collecting risk-adjusted premiums but rising costs can cause the poor and sick to lose coverage. Social health insurance compulsorily collects premiums from a broad base to ensure universal coverage unlike private systems. Donor funding significantly finances developing countries' healthcare through government systems or private organizations.
Healthcare economics & financing
This document discusses key topics in healthcare economics including health economics, demand and supply in healthcare markets, economic objectives in healthcare like efficiency and equity, concepts of economic efficiency applied to hospitals, healthcare expenditure trends globally and nationally, and priority areas for investing in health. It provides an overview of these essential healthcare economics concepts in 3 sentences or less.
Understanding the concept of Universal Health Coverage: UHC and Health Financing
Presentation by Dr. Gafar Alawode at the Healthcare Financing Workshop Training held February 2017 in Abuja, Nigeria.
Health sector reforms
One of the toughest aspect of health care system for medicos to understand. Multidisciplinary understanding is required to understand reform process.
Universal health coverage
The World Health Organization was founded on the principle of universal health coverage and achieving the highest level of health for all people. World Health Day on April 7th aims to inspire and guide countries toward achieving universal health coverage through a series of events in 2018. Currently half the world's population lacks access to needed health services, and countries need to extend coverage to one billion more people by 2023 to meet global targets. World Health Day will highlight the need for universal coverage and benefits it provides.
Reasons Why You Need An Experienced Account Manager
The document discusses several key driving forces that will shape the future of the pharmaceutical and biotech industries, including models of change in healthcare, the quest for value over cost and quality, and various political scenarios and their implications. It analyzes trends in healthcare spending, quality, and reform proposals. The main points are that a physician-centric view is no longer sufficient; affordability and third party perspectives must be considered; assumptions about specialty drug models may be overly optimistic; and partnerships with payers are necessary to develop strategically sound plans for new markets and customers.
MetroHealth presentation
The document provides context on MetroHealth, a public safety-net hospital in Cuyahoga County. It describes MetroHealth's mission of providing accessible healthcare to all, its role as a major provider for the uninsured and Medicaid patients in the county, and the financial challenges it faces due to its large burden of uncompensated care and reductions in government funding. The document outlines MetroHealth's actions to strengthen its finances through operational and strategic transformations, but notes ongoing challenges including an aging infrastructure and uncertainties surrounding healthcare reform.
More Related Content
What's hot
Health care financing
The document summarizes healthcare financing in India. It discusses that healthcare financing aims to ensure access to health services. The key principles are generating revenue, pooling funds for cross-subsidization between rich/poor and healthy/sick, and purchasing efficient services. In India, healthcare is financed primarily through out-of-pocket payments by households, while government expenditure is low compared to other countries. Reforms like NRHM and RSBY aim to increase public allocation to healthcare. Challenges include expanding coverage with limited resources and improving spending efficiency.
Introduction to Health Systems & Health Services Systems
The document provides an overview of a course on health service systems and health systems. It discusses several topics that will be covered in the course, including major issues in organizing health services, assessing population health status, analyzing healthcare access and costs. The course will also examine sociopolitical, economic, and ethical issues facing public health systems. Students will learn about different components of health systems through mini-lectures, discussions, and by analyzing case studies.
Health Sector Reforms prersentation
The document discusses health sector reforms in India. It provides context on the need for reforms due to fiscal constraints and poor social indicators. Key reforms introduced include decentralization, increasing human resources, financial reforms, reorganizing the existing health system, improving health management information systems, increasing community involvement, and ensuring quality. National initiatives like the National Rural Health Mission aim to promote equity, efficiency, quality and accountability in primary healthcare. The overall goal of health sector reforms is to improve access to healthcare and ultimately population health outcomes.
What is a health system? What is health system strengthening?
What is a health system? What is health system strengthening?Collaboration for Health Policy & Systems Analysis in Africa (CHEPSAA)
The document defines a health system as consisting of all organizations, people, and actions whose primary purpose is to promote, restore, or maintain health. It discusses health systems as complex adaptive systems with many interacting elements. It presents several conceptual frameworks for analyzing health systems, including the WHO health system building blocks and the Antwerp health system dynamics framework. It then discusses the concept of health system strengthening and changing global approaches to improving health systems over time, moving from a disease-focused approach to a more holistic health system strengthening approach.Quality in Healthcare Organizations
This document discusses the fundamentals of quality improvement and introduces key concepts such as measuring quality of care, common quality issues in healthcare, and the role of health information technology in improving patient safety and care quality. It provides an overview of quality improvement initiatives in the US such as meaningful use and accountable care organizations that aim to enhance care through the use of health IT.
US health care system overview 1
The document summarizes the major characteristics of the US healthcare delivery system. It notes that the US system has no central governing agency and little integration between parts of the system. It is technology-driven, focuses on acute care, and is high in costs but unequal in access, resulting in average health outcomes. The US relies more on private sector involvement compared to other developed countries where government plays a larger role.
Health sector reforms- INDIA
HEALTH SECTOR REFORMS- INDIA
Slides contain;
Reforms & Health System
Definition- HSR
Introduction
Financial reforms
Structural re-organization
Communication
Quality Assurance
Convergence
Public Private Partnership
Ways forward for effective HSR
Conclusion and points for Consideration
End
Health system
The document discusses healthcare systems and financing in Bangladesh. It provides an overview of Bangladesh's healthcare system, which is led by the Ministry of Health and Family Welfare and delivers services through two branches - the Directorate General of Health Services and the Directorate General of Family Planning. Non-governmental organizations also play an important role in service delivery. The system includes various types of public health facilities at the national, divisional, district, upazila, union and ward levels. It also discusses urban health systems managed by city corporations, and describes the main organizations responsible for health financing in Bangladesh, including the Ministry of Health, social security organizations, and private health insurance funds.
Concept of efficiency,effectivenes,Role of health care financing
Efficiency refers to performing with minimum wasted effort or expense. It is measured by the ratio of useful output to total input. There are several types of efficiency including economic, market, operational, productive, and X efficiency. Equity means fairness and is concerned with equal access and treatment. Horizontal equity means equal treatment of equals while vertical equity means unequal treatment of unequals. Elasticity of demand refers to the responsiveness of quantity demanded to a change in price. Demand can be elastic, inelastic, perfectly inelastic, perfectly elastic, or unitary elastic. The roles of health care financing include mobilizing resources, setting incentives for providers, and ensuring access to care. Financing functions include revenue collection, risk pooling, and purchasing of
Universal Health Coverage (UHC) Day 12.12.14, Nepal
This presentation is made on the first ever Universal Health Coverage (UHC) Day 12.12.14 celebration in Nepal by Nepal Health Economics Association (NHEA).
Health care delivery system in usa
The US health system is complex, relying on government, private markets, and charities. It consists of private health insurance, government programs like Medicare and Medicaid, and a public health system. Major components include private physicians and hospitals, as well as health maintenance organizations. The system faces rising costs and led to the 2010 Affordable Care Act which expanded insurance coverage.
Health Financing Functions: Risk Pooling
Presentation by Dr. Elaine Baruwa, Abt Associates, at Haiti's International Conference on Access to Health Care for All in Haiti: Challenges and Perspectives for Funding, April 28-29, 2015, Haïti
Universal Health Coverage
Understanding the concept of Universal Health Coverage (UHC) and how can we reach it, both globally and also in India. The presentation also includes HLEG report , which is the proposed architecture for India's guide to reach UHC.
Hospital business plan sample
The document provides an executive summary for a business plan for Project E, which will be Botswana's first private psychiatric hospital. It outlines the company's goals of increasing beds and admissions over time. Financial projections show an investment need of $9 million with positive cash flow and returns expected. The management team is experienced in the mental healthcare field.
Health system functions and structure
A health system consists of all organizations, people and actions whose primary intent is to promote, restore or maintain health .
Healthcare financing
Tax-based systems finance healthcare through taxes collected from the entire population of taxpayers, allowing risks to be pooled across a large group. This subsidizes care for the poor and sick by transferring wealth from the rich and healthy. However, overuse of free services remains a problem. Pay-as-you-go user fee systems represent a market-based solution but fees disproportionately reduce access for the poor. Risk-based private insurance guarantees entitlement by collecting risk-adjusted premiums but rising costs can cause the poor and sick to lose coverage. Social health insurance compulsorily collects premiums from a broad base to ensure universal coverage unlike private systems. Donor funding significantly finances developing countries' healthcare through government systems or private organizations.
Healthcare economics & financing
This document discusses key topics in healthcare economics including health economics, demand and supply in healthcare markets, economic objectives in healthcare like efficiency and equity, concepts of economic efficiency applied to hospitals, healthcare expenditure trends globally and nationally, and priority areas for investing in health. It provides an overview of these essential healthcare economics concepts in 3 sentences or less.
Understanding the concept of Universal Health Coverage: UHC and Health Financing
Presentation by Dr. Gafar Alawode at the Healthcare Financing Workshop Training held February 2017 in Abuja, Nigeria.
Health sector reforms
One of the toughest aspect of health care system for medicos to understand. Multidisciplinary understanding is required to understand reform process.
Universal health coverage
The World Health Organization was founded on the principle of universal health coverage and achieving the highest level of health for all people. World Health Day on April 7th aims to inspire and guide countries toward achieving universal health coverage through a series of events in 2018. Currently half the world's population lacks access to needed health services, and countries need to extend coverage to one billion more people by 2023 to meet global targets. World Health Day will highlight the need for universal coverage and benefits it provides.
What's hot (20)
Introduction to Health Systems & Health Services Systems
Introduction to Health Systems & Health Services Systems
What is a health system? What is health system strengthening?
What is a health system? What is health system strengthening?
Concept of efficiency,effectivenes,Role of health care financing
Concept of efficiency,effectivenes,Role of health care financing
Universal Health Coverage (UHC) Day 12.12.14, Nepal
Universal Health Coverage (UHC) Day 12.12.14, Nepal
Understanding the concept of Universal Health Coverage: UHC and Health Financing
Understanding the concept of Universal Health Coverage: UHC and Health Financing
Similar to Profit vs. Non-Profit Health Institutions
Reasons Why You Need An Experienced Account Manager
The document discusses several key driving forces that will shape the future of the pharmaceutical and biotech industries, including models of change in healthcare, the quest for value over cost and quality, and various political scenarios and their implications. It analyzes trends in healthcare spending, quality, and reform proposals. The main points are that a physician-centric view is no longer sufficient; affordability and third party perspectives must be considered; assumptions about specialty drug models may be overly optimistic; and partnerships with payers are necessary to develop strategically sound plans for new markets and customers.
MetroHealth presentation
The document provides context on MetroHealth, a public safety-net hospital in Cuyahoga County. It describes MetroHealth's mission of providing accessible healthcare to all, its role as a major provider for the uninsured and Medicaid patients in the county, and the financial challenges it faces due to its large burden of uncompensated care and reductions in government funding. The document outlines MetroHealth's actions to strengthen its finances through operational and strategic transformations, but notes ongoing challenges including an aging infrastructure and uncertainties surrounding healthcare reform.
Final Pocahontas Memorial Hospital Clinic Report
This document provides a report on Pocahontas Memorial Hospital's proposal to build a satellite clinic. It assesses the feasibility of the clinic by identifying stakeholders, environmental challenges, conducting a market analysis, and performing a SWOT analysis. The report finds that key stakeholders include employees, patients, families, and the board of directors. Challenges include staffing shortages, outdated equipment, and funding constraints due to the rural environment and low population incomes. However, the market analysis shows an opportunity for increased patients and revenues under healthcare reforms. The SWOT analysis identifies strengths in community health focus and clinic experience, but also weaknesses in size, transportation barriers, and staffing shortages. Overall recommendations support the satellite clinic to expand
Will There Be a Productivity Revolution in Health Care? - David Cutler
Health care is poised to undergo a revolution in productivity. With changes in organization and financing of care, we could improve productivity in medical practices, and for the system as a whole. The talk will describe how health care productivity can be increased, and the paths that might be taken with or without reform.
Will There Be a Productivity Revolution in Health Care? - David Cutler
Health care is poised to undergo a revolution in productivity. With changes in organization and financing of care, we could improve productivity in medical practices, and for the system as a whole. The talk will describe how health care productivity can be increased, and the paths that might be taken with or without reform.
Graduate Case Presentation - Tufts NEMC
Slide deck I created for a group presentation on a graduate level case study based on conditions surrounding Tufts NEMC circa 2003.
6 3 1C A S ERiverview Regional Medical Center.docx
6 3 1
C A S E
Riverview
Regional Medical
Center: An HMA
Facility
This case was written by Woodrow D. Richardson, Ball State University, and Donna
J. Slovensky, The University of Alabama at Birmingham. It is intended to be used
as a basis for class discussion rather than to illustrate either effective or ineffec-
tive handling of an administrative situation. Used with permission of Woody
Richardson and Donna Slovensky.
1 1
Matt Hayes, executive director of Riverview Regional Medical
Center (RRMC), reviewed the performance indicators for the 2004
fiscal year (see Exhibit 11/1). As he studied the numbers, he men-
tally reviewed key events and decisions over the past year that had
contributed to some of the more dramatic changes in the annual
profile. And, he considered what new challenges might confront him
now that his chief competitor, Gadsden Regional Medical Center
(GRMC), had a new executive director who would almost certainly
attempt to alter the status quo in the local hospital market.
Health Care Providers
In 1993, Merrill Lynch predicted: “In the larger urban areas, HMOs
would . . . continue to be the coordinator and provider of health care
services. However, in nonurban markets, the hospital would be the
both11.indd 631both11.indd 631 11/11/08 11:56:06 AM11/11/08 11:56:06 AM
C A S E 1 1 : R I V E R V I E W R E G I O N A L M E D I C A L C E N T E R6 3 2
cornerstone and coordinator of health care services for the health alliance purchasing
cooperatives which would be formed under managed competition proposals.”
At the individual provider level, some experts insisted that the financial power
base was moving away from solo practices and independent small groups toward
integrated, cost-competitive, comprehensive systems that produced a single patient
bill including the charges of the physicians, the hospital, and the outpatient
services. Integrated systems required a corporate structure to facilitate sharing
of capitated risk. Throughout the 1990s, mergers and other types of strategic
alliances between physicians’ practices, and between hospitals and physicians’
practices, had increased in an effort to reduce costs and become price competi-
tive. Small group practices often lacked the administrative and management
expertise as well as the material resources necessary to improve efficiency. They
were advised to look for such capabilities when they sought potential partners.
Many physicians remained skeptical of mergers, partnerships, or alliances offer-
ing any competitive advantage. That skepticism occurred most often in areas
where managed care was absent or limited. Exhibit 11/2 shows the penetration
of managed care in selected southern states.
Rural and Nonurban Health Care Market
Forty-nine percent of the United States population resided in counties classified as
rural or nonurban. Nonurban areas had 44 percent fewer doctors per 100,000 resi-
dents than urban-designated areas..
6 3 1CASERiverview Regional Medical Center An.docx
6 3 1
CASE
Riverview
Regional Medical
Center: An HMA
Facility
This case was written by Woodrow D. Richardson, Ball State University, and Donna
J. Slovensky, The University of Alabama at Birmingham. It is intended to be used
as a basis for class discussion rather than to illustrate either effective or ineffec-
tive handling of an administrative situation. Used with permission of Woody
Richardson and Donna Slovensky.
11
Matt Hayes, executive director of Riverview Regional Medical
Center (RRMC), reviewed the performance indicators for the 2004
fiscal year (see Exhibit 11/1). As he studied the numbers, he men-
tally reviewed key events and decisions over the past year that had
contributed to some of the more dramatic changes in the annual
profile. And, he considered what new challenges might confront him
now that his chief competitor, Gadsden Regional Medical Center
(GRMC), had a new executive director who would almost certainly
attempt to alter the status quo in the local hospital market.
Health Care Providers
In 1993, Merrill Lynch predicted: “In the larger urban areas, HMOs
would . . . continue to be the coordinator and provider of health care
services. However, in nonurban markets, the hospital would be the
both11.indd 631both11.indd 631 11/11/08 11:56:06 AM11/11/08 11:56:06 AM
C A S E 1 1 : R I V E RV I E W R E G I O N A L M E D I C A L C E N T E R6 3 2
cornerstone and coordinator of health care services for the health alliance purchasing
cooperatives which would be formed under managed competition proposals.”
At the individual provider level, some experts insisted that the financial power
base was moving away from solo practices and independent small groups toward
integrated, cost-competitive, comprehensive systems that produced a single patient
bill including the charges of the physicians, the hospital, and the outpatient
services. Integrated systems required a corporate structure to facilitate sharing
of capitated risk. Throughout the 1990s, mergers and other types of strategic
alliances between physicians’ practices, and between hospitals and physicians’
practices, had increased in an effort to reduce costs and become price competi-
tive. Small group practices often lacked the administrative and management
expertise as well as the material resources necessary to improve efficiency. They
were advised to look for such capabilities when they sought potential partners.
Many physicians remained skeptical of mergers, partnerships, or alliances offer-
ing any competitive advantage. That skepticism occurred most often in areas
where managed care was absent or limited. Exhibit 11/2 shows the penetration
of managed care in selected southern states.
Rural and Nonurban Health Care Market
Forty-nine percent of the United States population resided in counties classified as
rural or nonurban. Nonurban areas had 44 percent fewer doctors per 100,000 resi-
dents than urban-designated areas. Sinc.
Pacing Volume-to-Value Transition
PYA Principal Scott Clay presented “Pacing Volume-to-Value Transition” at the AlaHA Annual Meeting, June 8-11, 2016.
The presentation explored volume- to value-based reimbursement, and how the pace of change is unique to each organization. The presentation introduced a strategic framework to establish and communicate a pace of change befitting various organizations, explaining:
How government policies “set the floor” on the degree of change requested.
How to determine the pace of change in your market.
How to identify your organization’s current position and culture in relation to value-based payment models.
How to set and communicate the pace of transition consistent with your market and your organization’s culture.
HCA financail paper for Financial Managment
- Hospital Corporation of America (HCA) is one of the largest for-profit hospital operators in the US, with 162 hospitals and 113 outpatient surgery centers.
- It focuses on urban markets and is increasing investment in standalone surgical centers, which accounted for 38% of profits in 2014.
- HCA has significant debt of over $29 billion, making it highly leveraged and exposing it to interest rate risk. However, it has access to capital to fund expansion.
HCS 586 Final Strategic Plan for Acquisition of Altru Health System
The document provides a strategic plan for Mayo Health System to acquire Altru Health System. The plan includes maintaining Mayo's mission, vision, and values. It outlines the organizational structure with Mayo as the parent organization. The plan discusses the environmental analysis, strategic goals, and 3-5 year goals of the combined systems. It addresses the financial plan, implementation barriers and contingencies. Key leaders are identified for both systems until new elections in 2020. The acquisition aims to expand services while upholding the commitment to patient-centered care.
C H A P T E R 5S T R A T E G I C P L A N N I N G A N D
C H A P T E R 5
S T R A T E G I C P L A N N I N G
A N D S W O T A N A L Y S I S
I s k a t e w h e r e t h e p u c k i s g o i n g t o b e , n o t w h e r e i t
h a s b e e n .
— W a y n e G r e t z k y
K e y T e r m s a n d C o n C e p T s
➤➤ Force➤field➤analysis
➤➤ Opportunities
➤➤ Strengths
➤➤ SWOT➤analysis
➤➤ Threats
➤➤ Weaknesses
9 1
Excerpted from Essentials of Strategic Planning in Healthcare by Jeffrey P. Harrison
(Health Administration Press, 2010).
9 2 E s s e n t i a l s o f S t r a t e g i c P l a n n i n g i n H e a l t h c a r e
In T r o d u C T I o n
Healthcare organizations must continually make adjustments to maintain optimal func-
tion (Christiansen 2002). A number of different techniques can be used to determine
where adjustments need to be made. One essential technique involves a discussion of an
organization’s strengths, weaknesses, opportunities, and threats, commonly called SWOT
analysis. SWOT analysis has been used extensively in other industries but has not been
widely used in healthcare (Kahveci and Meads 2008).
SWOT analysis is a precursor to strategic planning and is performed by a panel of
experts who can assess the organization from a critical perspective (Gibis et al. 2001). This
panel could comprise senior leaders, board members, employees, medical staff, patients,
community leaders, and technical experts. Panel members base their assessments on utili-
zation rates, outcome measures, patient satisfaction statistics, organizational performance
measures, and financial status. While based on data and facts, the conclusions drawn from
SWOT analysis are an expert opinion of the panel.
de f I n I T I o n
SWOT analysis is an examination of an organization’s internal strengths and weaknesses,
its opportunities for growth and improvement, and the threats the external environment
presents to its survival. Originally designed for use in other industries, it is gaining in-
creased use in healthcare.
sT e p s I n sWoT an a l y s I s
The primary aim of strategic planning is to bring an organization into balance with the
external environment and to maintain that balance over time (Sackett, Jones, and Erdley
2005). Organizations accomplish this balance by evaluating new programs and services
with the intent of maximizing organizational performance. SWOT analysis is a prelimi-
nary decision-making tool that sets the stage for this work.
Step 1 of SWOT analysis involves the collection and evaluation of key data. De-
pending on the organization, these data might include population demographics, com-
munity health status, sources of healthcare funding, and/or the current status of medical
technology. Once the data have been collected and analyzed, the organization’s capabilities
in these areas are assessed.
In Step 2 of SWOT analysis, data on the organization are collected and sorted into
four categories: strengths, weaknesses, opportunities, and threats. Stre ...
Definitions of the quality of medical care are no longer left to cli.docx
Definitions of the quality of medical care are no longer left to clinicians who decide for themselves what technical performance constitutes “good care.” Name one (1) other dimension of quality care and why is it important?
What is the primary method of continuous quality improvement (CQI) in health care, and what is its underlying premise?
Since an ever-increasing amount of research is funded by commercial companies, what is your opinion on a requirement for authors of scientific studies who receive income from these companies to disclose funding sources in their scientific publications?
Future of Health Care Questions:
Today’s not-for-profit hospitals and health systems are commonly multi-billion dollar tax-exempt organizations. What is your position on the new federal scrutiny upon, and reporting requirements for justifying the charitable missions of not-for-profit hospitals and health systems?
In 1999, the Institute of medicine report,
To Err is Human,
generated a brief flurry of concerns about avoidable hospital deaths. While progress has been made in addressing system errors and deficiencies, it remains inconsistent across the nation’s hospitals. Fourteen years after this report, is it time for the professions, payers and the public to demand corrections of system problems in an accountable, transparent and publicly disclosed manner? What form can or should these demands take?
.
Chapter 4Determinants of the Utilization of Health Car.docx
This document provides learning objectives and content for several chapters on health care marketing and strategy. It covers factors that influence individuals' decisions to seek health care, including personal characteristics like age, gender, and income. It also discusses the major participants in health care systems, like providers, payers, suppliers and government. Additionally, it addresses strategic planning steps for health care organizations, including defining goals and conducting environmental analyses. Key trade-offs around cost, quality and access are also summarized. The document examines models for understanding different health care systems and the stakeholders involved. It analyzes how consumers and organizations make buying decisions in the context of health care.
Copyright 2014 American Medical Association. All rights reserv.docx
This study analyzed compensation data for 1877 CEOs of 2681 nonprofit US hospitals. The CEOs had a mean compensation of $595,781 and median of $404,938 in 2009. CEO compensation was higher for those managing larger hospitals, more hospitals, and major teaching hospitals. The study examined if compensation was associated with various hospital metrics. Compensation was higher for hospitals with more advanced technology and higher patient satisfaction, but was not associated with financial metrics, quality measures like mortality and readmissions, or community benefit provided. This suggests CEO pay was linked to some measures of hospital performance but not others aimed at quality and community impact.
Side PanelExpand side panel Profit and.docx
For-profit corporations aim to generate profit for shareholders, while not-for-profit corporations have a charitable mission but are still subject to regulatory pressures. Not-for-profit hospitals must meet requirements under Section 501(c)(3) of the U.S. tax code to maintain their tax-exempt status, such as operating an emergency room open to all patients regardless of ability to pay. The Affordable Care Act introduced additional requirements for not-for-profit hospitals around conducting a community health needs assessment and adopting financial assistance policies.
Professor H.E. Frech III: Accountable Care Organisations
Accountable care organizations (ACOs) are proposed collaborations of healthcare providers that would be accountable for quality outcomes and reducing healthcare spending growth. Under ACOs, providers could share in savings realized from meeting quality standards and keeping costs below a set benchmark. However, there are concerns that ACOs could harm competition by giving providers increased market power if they integrate horizontally. Properly designed, ACOs may help achieve managed care savings in fee-for-service Medicare while decentralizing decision making, but weak financial incentives and regulatory complexity may limit their effectiveness.
8 in 10 Hospitals Stand Pat on Population Health Strategy, Despite Uncertaint...
A 2017 survey by Health Catalyst shows that despite uncertainty about the future of the Affordable Care Act, 80 percent of healthcare executives have not paused or otherwise changed their population health management strategy. 68 percent said that PHM is “very important” to their healthcare delivery strategy, while fewer than 3 percent said it was not important at all. The results show that executives view the move to value-based care as inevitable, and they view a PHM strategy as an integral part of their future efforts.
PPACA of 2010 brought many changes to the types of provider organiza.docx
PPACA of 2010 brought many changes to the types of provider organizations available. ACOs and PCMHs are two new organizations formed under PPACA. Using the readings this week, discuss the origin, structure, and purpose of the new organizations formed under PPACA.
Using South University Online Library (for example, CINAHL) or the Internet, search any three articles from the list below and evaluate the challenges and opportunities facing payers and providers as ACOs and PCMHs are implemented:
The patient-center medical home and managed care: Times have changed, some components have not (Baird, 2011).
Patient-centered medical homes: Will health care reform provide new options for rural communities and providers? (Bolin, Gamm, Vest, Edwardson, & Miller, 2011)
Accountable Care Organizations: The case for flexible partnerships between health plans and providers (Goldsmith, 2011).
Payment reform for primary care within the accountable care organization a critical issue for health system reform (Goroll & Schoenbaum, 2012).
Accountable care organizations, the patient-centered medical home, and health care reform: What does it all mean? (Longworth, 2011)
Implementing accountable care organizations: Ten potential mistakes and how to learn from them (Singer & Shortell, 2011).
Based on your research, summarize your findings on the selected topics and compile your observations in a 4-5 Microsoft Word document.
Support your responses with examples.
Cite any sources in APA format.
References
:
Baird, M. A. (2011). The patient-center medical home and managed care: Times
have changed, some components have not.
The Journal of the American
Board of Family Medicine
,
24
(6), 630–632.
Bolin, J. N., Gamm, L., Vest, J. R., Edwardson, N., & Miller, T. R. (2011).
Patient-centered medical homes: Will health care reform provide new
options for rural communities and providers?
Family & Community
Health
,
34
(2), 93–101.
Goldsmith, J. (2011). Accountable Care Organizations: The case for flexible
partnerships between health plans and providers.
Health Affairs
,
30
(1), 32–40.
Goroll, A. H., & Schoenbaum, S. C. (2012). Payment reform for primary care
within the accountable care organization a critical issue for health system
reform. JAMA:
The Journal of the American Medical Association
,
308
(6), 577–578.
Support your responses with examples.
Cite ALL sources in APA format. NO PLAGIARSM.......assignmant will be check by TURNITIN....
.
ProcessflowchartQualityQualitymanagementRootcauseana.docx
Process flowchart
Quality
Quality management
Root cause analysis
Six Sigma
Standard deviation
To-be process
Variability
DISCUSSION QUESTIONS
1. In which three categories can process reengineering improve performance?
2. Define and describe the key shapes used in process flowcharting.
3. What is the difference between a Pareto chart and a control chart? When should each
be used?
4. What are the major phases in the process improvement methodology?
5. What are the major types of customer or patient service-level issues that exist in health
care?
6. When should hospitals benchmark against non-health-care organizations? Under which
circumstances?
REFERENCES
Bryant, S. W. (2004). JCAHO coordinator’s standards. Marblehead, MA: HCPro.
George, M. L. (2003). Lean Six Sigma for service: How to use Lean Speed and Six
Sigma quality to improve services and transactions. New York, NY: McGraw-Hill.
Hammer, M., & Champy, J. (1993). Reengineering the corporation: A manifesto for
business revolution. New York, NY: HarperCollins.
Harrington, H. J., Esseling, E. K. C., & and van Nimwegen, H. (1997). Business process
improvement workbook: Documentation, analysis, design, and management of
business process improvement. New York, NY: McGraw-Hill.
Langabeer, J. R. (2009). Performance improvement in hospitals and health systems.
Chicago, IL: Healthcare Information and Management Systems.
Langabeer, J. R., DelliFraine, J. L., Heineke, J., & Abbass, I. (2009). Implementation of
Lean and Six Sigma quality initiatives in hospitals: A goal theoretic perspective.
Operations Management Research, 2(1–4), 13–27.
Maslow, A. H. (1998). Maslow on management. New York, NY: Wiley.
Helton, J., Langabeer, I. J. R., Helton, J., & Langabeer, J. R. I. (2015). Health care operations management. Retrieved from http://ebookcentral.proquest.com
Created from apus on 2020-01-14 17:16:50.
C
o
p
yr
ig
h
t
©
2
0
1
5
.
Jo
n
e
s
&
B
a
rt
le
tt
L
e
a
rn
in
g
,
L
L
C
.
A
ll
ri
g
h
ts
r
e
se
rv
e
d
.
PART I
Operations, Systems, and Financial
Management
Part I of this text provides the reader with a foundation of operations management and explains
its role in improving health care’s financial and business condition. Health care activities and
processes are complex. To perform optimally, they must be managed as a system. Operations
and systems management requires knowledge of process improvement, quality, finance, and
many other business practices. As a service industry, financial outcomes are driven primarily
by labor and supply costs, so an understanding of the income statement and the use of key ratios
to manage these areas is provided. Understanding the concepts of operations management, and
its relationship to financial margins, is also explored.
Chapter 1 offers an overview of the discipline of operations and systems management and
that of management in general. Goals of operations management, from cos ...
Similar to Profit vs. Non-Profit Health Institutions (20)
Reasons Why You Need An Experienced Account Manager
Reasons Why You Need An Experienced Account Manager
Will There Be a Productivity Revolution in Health Care? - David Cutler
Will There Be a Productivity Revolution in Health Care? - David Cutler
Will There Be a Productivity Revolution in Health Care? - David Cutler
Will There Be a Productivity Revolution in Health Care? - David Cutler
6 3 1C A S ERiverview Regional Medical Center.docx
6 3 1C A S ERiverview Regional Medical Center.docx
6 3 1CASERiverview Regional Medical Center An.docx
6 3 1CASERiverview Regional Medical Center An.docx
HCS 586 Final Strategic Plan for Acquisition of Altru Health System
HCS 586 Final Strategic Plan for Acquisition of Altru Health System
C H A P T E R 5S T R A T E G I C P L A N N I N G A N D
C H A P T E R 5S T R A T E G I C P L A N N I N G A N D
Definitions of the quality of medical care are no longer left to cli.docx
Definitions of the quality of medical care are no longer left to cli.docx
Chapter 4Determinants of the Utilization of Health Car.docx
Chapter 4Determinants of the Utilization of Health Car.docx
Copyright 2014 American Medical Association. All rights reserv.docx
Copyright 2014 American Medical Association. All rights reserv.docx
Professor H.E. Frech III: Accountable Care Organisations
Professor H.E. Frech III: Accountable Care Organisations
8 in 10 Hospitals Stand Pat on Population Health Strategy, Despite Uncertaint...
8 in 10 Hospitals Stand Pat on Population Health Strategy, Despite Uncertaint...
PPACA of 2010 brought many changes to the types of provider organiza.docx
PPACA of 2010 brought many changes to the types of provider organiza.docx
ProcessflowchartQualityQualitymanagementRootcauseana.docx
ProcessflowchartQualityQualitymanagementRootcauseana.docx
Profit vs. Non-Profit Health Institutions
- 1. For Profit (FP) vs. Not For Profit (NFP) Health Organizations Andrew Helicher HPA 520 November 4, 2009
- 3. Observations
- 4. Trends
- 6. Observations
- 7. Trends
- 10. Incubators of innovation: develop services without existing markets
- 11. Positive public perception: mission over margin
- 12. Limited funding sources for capital investments
- 13. Slower to adapt to market changes to serve public
- 14. Unable to pay for top managerial ability (Fair Market Value) Schlesinger and Gray, 2006
- 17. Negative public perception: margin over mission
- 18. Exploit Medicare reimbursement loopholes
- 19. Cannot accept donations (only 3.6% of NFP revenue)2 Sloan, 1998 Frank and Salkever, 2000
- 21. Observations
- 22. Trends
- 23. Key Findings6
- 24. Governance 7 Behavior (CEO Turnover) Stakeholders Governing Board Mission Investors FP Business People Economic Viability Low Income Community FPNFP Community Leaders Quality of Care High Admin Expenses Physicians FPNFP Physicians / Nurses Donors NFP Foundation Members Community Benefit High charity care Churchs NFP Religious Leaders Eldenberg, Hermalin, Weisbach & Wosinska, 2001
- 26. More insured populationsSloan, 1998
- 28. Observations
- 29. Trends
- 30. Key Findings9
- 31. Ownership Trend – NFP to FP 10 19971 20072 ↑1% ↓2% - Public - For Profit - Not For Profit Castaneda & Falaschetti, 2008 AHA, 2009
- 33. Medicare RPS to PPS
- 34. Growth of Managed Care
- 37. Shrinking demand
- 38. Rising uninsured
- 43. Culture: business-oriented hospital board members
- 44. Don’t want to merge with local competitorsSloan, 1998 Cutler & Horwitz, 2000
- 45. NFP Excesses or Necessities? Carreyrou & Martinez, 2008 Cleverly, 2008 12
- 47. Observations
- 48. Trends
- 49. Key Findings13
- 51. Ownership status affects location choice, which influences hospital behavior and performance
- 52. Ownership status determines hospital board composition, definition of mission, and resulting behavior
- 54. References 16 Cleverly, W. (2008) Not-For-Profit Hospitals: Still a Community Value. Healthcare Financial Management. June 2008. Carryrou, J. & Martinez, B. (2008) Nonprofit Hospitals, Once For the Poor, Strike It Rich. The Wall Street Journal. April 8, 2008. American Hospital Association (2009) Fast Facts on American Hospitals. Retrieved from http://www.aha.org/aha/resource-center/Statistics-and-Studies/fast-facts.html. April 13, 2009. Healthcare Financial Management Association (2009) Comments on Attributes of Tax-Exempt Healthcare Providers. Retrieved from http://www.hfma.org/library/compliance/taxexempt/400662.htm. June 18, 2009. Eldenburg, L., Hermalin, B., Weisbach, M., Wosinka, M. (2001) Hospital Governance, Performance Objectives, and Organizational Form. National Bureau of Economic Research. Working Paper 8201. April 2001. Falaschetti, D., & Castaneda, M. (2008) Does Hospital’s Profit Status Affect its Operational Scope? Springer Science and Business Media, LLC. October 5, 2008. Sloan, F. (1998) Commercialism in Nonprofit Hospitals. Journal of Policy Analysis and Management, Vol. 17, No. 2. Spring, 1998. Schlesinger, M. & Gray, B. (2006) How Nonprofits Matter in American Medicine, and What to Do About It. Health Affairs, web exclusive. June 20, 2006. Cutler, D. (2000) The Changing Hospital Industry. Chicago: University of Chicago Press.
- 55. Meta-Analysis Studies Supporting FP or NFP Performance (Hospitals) Schlesinger & Gray, 2006 17