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Scenario You are the CFO of a rural hospital. During
ScenarioYou are the CFO of a rural hospital. During a recent review of the organization’s
financial status, the hospital was deemed “at risk” for closure. Several factors contribute to
the at-risk designation, including the state’s decision to opt-out of the Medicaid expansion
program, the aging population which requires more expensive care, and the changes in
reimbursement from Medicare. These challenges have resulted in rural facility closures
across the country. As part of the strategic management team, you are charged with
reviewing various facility units and making recommendations that may avoid closure. You
determine that based on the profitability reports, the OB/GYN unit of the facility is
underperforming in several key financial areas.InstructionsIn a written proposal to the
hospital CEO, Administrator, and CMO, discuss the following:Identify potential challenges
related to the OB/GYN unit’s performance.Explain potential trends in the community
impacting health consumer utilization patterns.Explain the potential benefits of
reorganization within the unit and how reorganization could improve its financial
status.Recommend a course of action and the implications that those actions will have for
patients, providers, and investors (i.e., how might closure affect the community or how
might new service offerings, such as midwife services, improve profitability). Rubric -Clear
and thorough identification of specific challenges related to the OB/GYN unit’s performance.
Includes comprehensive descriptions of the specific challenges with multiple examples.–
Clear and thorough explanation of potential trends in the community impacting health
consumer utilization patterns. – Clear and thorough explanation of the potential benefits of
reorganization within the unit and how reorganization could improve its financial status. –
Comprehensive recommendations for a course of action and the implications that those
actions will have on stakeholders. Includes multiple supporting examples for each
recommendation.

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PRIMARY CARE Scenario Type of care provided Scenario Question 1 Question 2 Care in this type of setting is delivered by physicians, physician assistants, nurse practitioners, and ad- vanced practice professionals. This area of health care is the most widely used, and it is a major focus of the Affordable Care Act of 2010, focusing on primary care providers and decreasing the focus on the utilization of specialty providers. As an administrator, you need to assess this situation: How would you determine if there was a true need for another receptionist? Do you need to reinstate the position or can you retrain the current number of employees? Why? As an administrator, describe the effects that labor shortages of key personnel and rising costs of labor have on profitability. How would you determine how to allocate your money? Be sure to think critically about the impact that quality outcomes and patient outcomes have on financial resources. A primary care clinic can be an individual-physician practice or a multiple-physician practice organized as a nonprofit or a for-profit facility. Multiple-physician practices generally specialize in cardiac, women’s health, pediatrics, or related services. You are the administrator of a local for-profit, multiple-physician community clinic owned by five local physicians, specializing in internal medicine, women’s health, pediatrics, orthopedics, and oncology. The clinic sees an average of 50 patients per day. Scheduling is centralized with two receptionists, and each specialty has four staff members to assist the physicians. All the physicians have visiting privileges at the area hospitals and frequently speak at local and national conferences on numerous preventative health care topics. The clinic is noted for its use of technology and has agreements in place with the local hospitals for web-based exchanges of health information on shared patients. Action Required: Your office just underwent an organizational change and one office receptionist was eliminated, saving the office $25, 000 per year in labor costs. However, there have been a number of complaints that all patients cannot be processed due to the increased flow of patients. Two weeks later you begin to hear that wait times for appointments have increased, and one specific patient was not able to be seen. That patient now has developed an infection and requires surgery. Question 3 Based on what you have learned so far in this course, what would be your plan of action for the next 30 days? What types of reports would you use to help support your decisions? Budget Considerations Operational Budget – This budget focuses on a broader view of the total operations of the organization in which all departments are reviewed for both their income potential and the costs associated with the work activities used to generate projected revenues. Each department will have its own budget for the managers to follow and on wh.

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In this assignment, you will demonstrate your mastery of the following course outcomes:  Analyze the impacts of various healthcare departments and their interrelationships on the revenue cycle  Compare third-party payer policies through analysis of reimbursement guidelines for achieving timely and maximum reimbursements  Analyze organizational strategies for negotiating healthcare contracts with managed care organizations  Critique legal and ethical standards and policies in healthcare coding and billing for ensuring compliance with rules and regulations  Evaluate the use of reimbursement data for its purpose in case and utilization management and healthcare quality improvement as well as its impact on pay for performance incentives Prompt You are now a supervisor within the patient financial services (PFS) department of a healthcare system. It has been assigned to you to write a white paper to educate other department managers about reimbursement. This includes how each specific department impacts reimbursement for services, which in turn impacts the healthcare organization as a whole. The healthcare system may include hospitals, clinics, long-term care facilities, and more. For now, your boss has asked you to develop a draft of this paper for the hospital personnel only; in the future, there may be the potential to expand this for other facilities. In order to complete the white paper, you will need to choose a hospital. You can choose one that you are familiar with or create an imaginary one. Hospitals vary in size, location, and focus. Becker’s Hospital Review has an excellent list of things to know about the hospital industry. Once you have determined the hospital, you will need to think about the way a patient visit works at the hospital you chose so you can review the processes and departments involved. There are several ways to accomplish this. Choose one of the following:  If you have been a patient in a hospital or if you know someone who has, you can use that experience as the basis for your responses.  Conduct research through articles or get information from professional organizations. Below is an example of how to begin framing your analysis. A patient comes in through the emergency department. In this case, the patient would be triaged and seen in the emergency department. Think about what happens in an emergency area. The patient could be asked to change into a hospital gown (think about the costs of the gown and other supplies provided). If the patient is displaying signs of vomiting, plastic bags will be provided and possibly antinausea medication. Lab work and possibly x-rays would be done. The patient could be sent to surgery, sent home, or admitted as an inpatient. If he or she is admitted as an inpatient, meals will be provided and more tests will be ordered by the physician—again, more costs and charges for the patient bill. Throughout the course, you will be gathering additional information th.

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I need the follwoing assignment: The project is the creation of a white paper. Much of what happens in healthcare is about understanding the expectations of the many departments and personnel within the organization. Reimbursement drives the financial operations of healthcare organizations; each department affects the reimbursement process regarding timelines and the amount of money put into and taken out of the system. However, if departments do not follow the guidelines put into place or do not capture the necessary information, it can be detrimental to the reimbursement system. An important role for patient financial services (PFS) personnel is to monitor the reimbursement process, analyze the reimbursement process, and suggest changes to help maximize the reimbursement. One way to make this process more efficient is by ensuring that the various departments and personnel are exposed to the necessary knowledge. For your final project, you will assume the role of a supervisor within a PFS department and develop a white paper in which the necessary healthcare reimbursement knowledge is outlined. The project is divided into three milestones, which will be submitted at various points throughout the course to scaffold learning and ensure quality final submissions. These milestones will be submitted in Modules One, Three, and Five. In this assignment, you will demonstrate your mastery of the following course outcomes:  † Analyze the impacts of various healthcare departments and their interrelationships on the revenue cycle  † Compare third-party payer policies through analysis of reimbursement guidelines for achieving timely and maximum reimbursements  † Analyze organizational strategies for negotiating healthcare contracts with managed care organizations  † Critique legal and ethical standards and policies in healthcare coding and billing for ensuring compliance with rules and regulations  † Evaluate the use of reimbursement data for its purpose in case and utilization management and healthcare quality improvement as well as its impact on pay for performance incentives Prompt You are now a supervisor within the patient financial services (PFS) department of a healthcare system. It has been assigned to you to write a white paper to educate other department managers about reimbursement. This includes how each specific department impacts reimbursement for services, which in turn impacts the healthcare organization as a whole. The healthcare system may include hospitals, clinics, long-term care facilities, and more. For now, your boss has asked you to develop a draft of this paper for the hospital personnel only; in the future, there may be the potential to expand this for other facilities. In order to complete the white paper, you will need to choose a hospital. You can choose one that you are familiar with or create an imaginary one. Hospitals vary in size, location, and focus. Becker’s Hospital Review has an excellent .

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