Amt Task 4

Trinity Community Hospital conducted a focused community health needs assessment centering on cancer, orthopedic and cardiovascular services. The information was obtained through a multitude of sources including: epidemiological surveys, focus groups, interviews with healthcare professionals and healthcare facilities’ planning guidelines.

The following is a summary of advantages and disadvantages of building, buying and leasing space for the new orthopedic line at Trinity Community Hospital. Included in this summary, is the option I recommend and my basis for this choice.

Company S is a new manufacturer entering the scooter market. The company’s objective is to motivate dealerships as intermediaries. Company S wants the existing scooter dealerships to sell its product instead of the competitions. The company will motivate the dealerships as intermediaries through Incentive Programs, Profit Opportunities, Sales Quotas, Decision Making, and Frequent/Timely Delivery.

The provisions of PPACA will affect Medicare’s payments to acute care hospitals and will constrain payment increases to these hospitals, restructure payments to address treatment inefficiencies, and then reshape Medicare’s disproportionate share hospital hospital subsidies. Also, the exception that permits physicians with ownership interests in a hospital to refer Medicare and Medicaid patients to that hospital will be eliminated for new doctor owned hospitals or those that did not meet certain criteria.

The PPACA, as amended by the Health Care Education Reconciliation Act of 2010, is far–reaching legislation that will change how millions of Californians access health care coverage. The PPACA, often referred to as federal health care reform, will also change the structure and availability of coverage, thereby making it easier for more Californians to purchase and maintain it.

Medicare has changed the way it pays hospitals for services delivered to clients with Medicare. Instead of only paying for the amount of services the hospital offers, Medicare also pays hospitals for providing top quality health care services. The Centers for Medicare and Medicaid Services (CMS), a federal agency that runs the Medicare program, is altering the way Medicare compensates for hospital care by giving rewards to those hospitals that delivers higher quality and higher value service to clients (Medicare.gov, n.d.). At the beginning of October 1, 2012, the Affordable Care Act (ACA) permits Medicare by reducing payments to acute care hospitals with surplus readmissions that are paid under CMS 's inpatient potential payment system (Medicare.gov, n.d.). Medicare has information regarding how the hospital 's quality care affects the disbursements it receives from Medicare. The Hospital Value-Based Purchasing (VBP) Program, created by the ACA,

Further plans involve opening a new facility in the tri-county area every six months for an additional two years. Our priorities in developing a comprehensive continuum of care for our patients are as follows: 1.) Emergent, critical analyses for the job descriptions and specializations these facilities must consider for operation and integral secondary and tertiary

system in America. (RAND, 2009). Some of the primary provisions pertain to augmenting health care

My role is of a CEO in Trinity Community Hospital, and I am tasked with the development of a new service line, i.e. an orthopedic center. For approval and buy-in purposes, I will present the findings to the board of directors. For all those in need of assistance, to provide quality healthcare is the mission of Trinity Community Hospital. Profitability and growth, service excellence, staff achievement, safety and quality are the four basic principles of success at the Community Hospital. The medical staff members and outstanding employees and emphasis on providing exceptional services and care to the patients are the features that distinguish the Community Hospital from other healthcare facilities. To consider for the community and the facility, the most valuable service determined for Trinity

Orthopedic services presently have the most strained services with the largest projected increases in cases and procedures over five years. There is also a lack of patient care coordinators and presentational education programs. To address this growth, TCH is planning to build a physical therapy and rehab center. Additionally, radiology will be expanded and a second MRI added. TCH has arranged to update their practices and improved their education and outreach programs. Conversely, TCH has neglected to plan for additional recruitment and retention of staff, mainly physicians and care coordinators. Furthermore, TCH has failed to address the need for more surgical suites to handle the 30% increase in inpatient

PPACA was initially envisioned to expand eligibility for Medicaid and Medicare. However, since Medicaid and Medicare are administered jointly through state and federal government, this provision could not take place after the Supreme Court determined that PPACA could not force states to expand their Medicaid program. The Court reasoned if states refused to expand their Medicaid program under the law, as it was written, then HHS would legally be entitled to withhold the state’s current Medicaid funding for non-compliance (Kaiser, 2015). Currently, an individual with an annual income that is within 133% of the federal poverty level is eligible for Medicaid, if living in a state that expanded Medicaid (Dixon, 2014). Under PPACA, the federal government

Pay for Performance programs aim to improve healthcare quality and efficiency standards by rewarding hospitals and physicians for better health outcomes in patients. The Affordable Care Act established a Pay for Performance program called the Hospital Value Based Purchasing program. This program, administered by the Centers for Medicare and Medicaid Services, incentivizes hospitals to improve the quality of care they provide. CMS achieves this by redistributing funds so that higher performing hospitals in terms of healthcare quality receive a greater proportion of funds in comparison to lower performing hospitals. Medicare pays for the Value Based Purchasing program by withholding a percentage of hospital payments starting with 1% in 2013

The five year strategic plan for Trinity Community is to introduce three new service lines: Orthopedic, Cardiovascular, Cancer services. Based on the Community Health Needs Assessment (CHNA), the orthopedic service line has highest projected increase in cases. Projected orthopedic cases will increase by 46% to 17,338 from 11,800, while inpatient joint and spine procedures increase by 30% and outpatient joint and spine procedures increase by 350%. The Burden of Musculoskeletal Diseases in the United States (BMUS) states that “Musculoskeletal diseases affect more than one out of every two persons in the United States age 18 and over, and nearly three out of four ages 65 and over.” ("BMUS: The Burden of Musculoskeletal Diseases in the United

Hospitals exist with the purpose of facilitating health care, alleviating pain and suffering, with increased improvement in recent times. An assessment of the Riverside Hospital community was conducted utilizing the hospital community as a partner model. Assessment was completed using data collection, and interviews with hospital staff, patients and family members. The hospital is comprised of several units specializing in different fields. Approaches used includes detailed analysis, surveys, demographics analysis, planning, intervention, and evaluation, for the process. The advancements in healthcare have been possible due to recent

Tulare Regional Medical Center is a small community hospital that is currently under construction for expansion to increase its daily census. This expansion is important for TRMC to attract new doctors and patient to their facility since TRMC is old and in need of new equipment and operating rooms. Due to the hospital being old and not equipped with the latest