Amt Task 4

1472 Words Dec 9th, 2013 6 Pages
Trinity Hospitals five year plan includes development of an orthopedic center, cardiovascular center and a cancer center. Task four asks for an assessment of the viability of one of these service lines. By assuming the role of the hospital CEO, I will evaluate the orthopedic center service line and present the findings to the board of directors for their approval.
Demand for Orthopedic Service Line As identified in the Trinity Community Hospital’s Community Needs Assessment, the demand for orthopedic services in the area is expected to increase by 46% in the next five years. Inpatient joint and spine procedure are projected to increase by 30% and outpatient joint and spine procedures are expected to increase by 350%. Trinity
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The PPACA involves many legislative changes that will affect hospital reimbursement. The PPACA requires every citizen in the United States to get health insurance and those that are noncompliant will face tax penalties. The PPACA requires all states to establish an American Health Benefit Exchange by 2014 to assure that health insurance is affordable to individuals and companies with 100 or less employees. The PPACA establishes a pay for performance program, which is a value-based purchasing (VBP) program in which Medicare pays hospitals based on their performance as compared to how they meet quality measures. Beginning in 2013 using the VBP program, hospitals will be paid based on their performance on many quality measures for acute myocardial infarction, pneumonia, heart failure, surgeries and hospital associated infections. Before the PPACA in 2010, Medicaid programs reimbursed 65 cents for every dollar charged. With the PPACA in place, Medicaid covers individuals up to 133% of the federal poverty level. The mandatory Medicaid income eligibility for children will increase from 100% to 133% of the federal poverty level. At the state level, benefits can be expanded to persons with higher incomes. Those that receive benefits through Medicaid cannot accept benefits through the exchange programs. The hospital will have the option to increase

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