Table 2 shows the diagnosis and procedure codes for selected cardiac and cancer surgeries. All cardiac and cancer surgeries were defined in a manner to maximize comparability among procedures as much as possible. In addition, all procedures were segregated by their severity and complexity. In some cases, cancer surgeries can be performed for patients whose primary diagnosis was not cancer. A colectomy is recommended for patients with severe diverticular colon diseases. Hence, this study excluded hospital admissions in which the primary diagnosis was not cancer surgeries.
Variable Definitions
The dependent variable of this study is transaction price of care. The transaction price refers to actual payments from insurers to providers, which
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Among hospital attributes from the AHA Annual Survey, this study controlled for hospital ownership, teaching status, and system/network affiliation. The AHA Annual Survey identifies four types of hospital ownership: 1) government, nonfederal; 2) nongovernment, not-for-profit; 3) investor-owned, for-profit; and 4) government, federal. This study defined hospital ownership types as private not-for-profit, private for-profit, and public hospitals. Teaching hospital was defined as an affiliated member hospital of the Council of Teaching Hospitals and Health Systems (COTH). As previously described, types of system affiliation are defined as centralized health physician insurance health system (CHPIHS), moderately centralized health system (MCHS), decentralized health system (DHS), and independent health system (IHS). The reference group of the health system/network variable is independent hospitals, which do not belong to any system or …show more content…
The vector Xit refers to the patient characteristics including age, sex, disease severity, comorbidity and health insurance plan type. Different sets of disease severity variables are adopted across procedures. Colectomy price equation includes partial laparoscopy, partial open surgery, and total open surgery (reference) variables. CABG price equation includes one vessel surgery (reference), two vessels surgery, three vessels surgery, and four or more vessels surgery. PCI price equation includes one stent surgery (reference), multiple stents surgery, one vessel surgery, multiple vessels surgery, thrombolytic infusion surgery. Three Elixhauser variables for the counts of comorbidities (1, 2, 3+) are included, with no comorbidity (0) constituting the reference category. Two plan types (POS and HMOs) are included; the reference category is all other fee-based plans. The vector Mjt refers to hospital j’s attributes, including private not-for-profit, private for-profit, teaching status, and system affiliation (CHPIHS, MSHS, DHS, IHS), and network affiliation. The reference categories for ownership, teaching status, and system affiliation are public hospitals, non-teaching hospitals, and independent hospitals. The vector Zht refers to local market conditions, including HMO penetration rate and the
In 1997 University of California, San Francisco (UCSF) merged its two public hospitals with Stanford’s two private hospitals. The two separate entities merged together to create a not-for-profit organization titled UCSF Stanford Health Care. The merger between the health systems at UCSF and Stanford seemed like a good idea due to the similar missions, proximity of institutions, increased financial pressure with cutbacks in Medicare reimbursements followed by a dramatic increase in managed care organizations. The first year UCSF Stanford Health Care produced a profit of $22 million, however three years later the health system had lost a total of $176 million (“UCSF-Stanford Merger,” n.d.). The first part of this paper will address reasons
H. (04/2015). Comprehensive Health Insurance: Billing, Coding & Reimbursement, VitalSource for Allen School of Health Sciences, 1st Edition. [Bookshelf Online]. Retrieved from https://online.vitalsource.com/#/books/9781323131503/
For the last five weeks research has been done on Kaiser Permanente, an organization that contains Kaiser Foundation Health Plan, Kaiser Foundation Hospitals and Permanente Medical Groups in eight regions. Since its inception in 1945, Kaiser Permanente has become the largest not-for-profit, integrated health care delivery system in the United States, serving 8.6 million members in eight regions: Northern and Southern California, Colorado, Georgia, Hawaii, the Mid-Atlantic States, Ohio, and the Northwest. About three quarters of the members are in California, the organization’s birthplace. It is the largest nonprofit integrated health care delivery system in the United States. Its mission is to provide affordable, high-quality health care services to improve the health of their members and the communities they serve. For the purpose of this research, focus will be on Northern California in a randomly selected hospital.
There are many types of organizations that may provide healthcare to a community. Organizations that provide healthcare services may seem similar however there are different ways a healthcare system may be structured. This paper is going to analyze the organizational structure of Hoag Hospital.
The intention of this research paper is to further understand the financial statement of four distinct hospitals located in the San Diego, California County. An analysis of the financial report for Sharp HealthCare, Scripps Health, Tri-City HealthCare, and Palomar Health will be briefly discussed individually on each important financial outcome’s Such as: assets, liabilities, revenue, expenses, hospital debt, and investments. To analyze further, a break down between the hospitals assets, liabilities, and revenue will be compared in the paper.
Through the history of health care, the standard of care changed from protecting our patient from injury and illness to a systemic entity to make money for insurance companies. Access to services and clinical outcomes are dependent on what health insurance providers will “pay” for in a clinical or community setting; as a result, patient safety, care and satisfaction has been negatively impacted.
A healthcare organization such has a private hospital are classified as non-profit or for-profit institutions. According to Alliance for advancing non-profit healthcare; “ About 60 percent of community
The debate on whether all healthcare institution should be non-profit rises many issues and they have been heavily debated. The best way to examine this to analyze if non-profit hospitals are in fact better that for
Though they are not entirely comprehensive tools, a great deal can be learned about a hospital or other healthcare organization for-profit or not-for-profit from an examination of their annual financial documents (Finkler & Ward, 2006). The balance sheet and statement of revenue and expense can both yield valuable clues even in the absence of other evidence about changes that might be occurring in the organization, a definition of the type and degree of certain problems that it might be facing, and potential opportunities for improvement in performance that might exist (Finkler & Ward, 2006). Comparing two or more years' worth of financial information yields even more valuable insights, tracking movement in the hospital or other organization's ability to finance its activities and thus continue providing services at the same level, quantity, and scope as current operation.
The Jackson Memorial Health System is based in Miami. This not-for-profit, county run organization has multiple sites, the main one being Jackson Memorial Hospital. The hospital has over 1550 licensed beds and is a teaching facility for the medical school at the University of Miami (JHS Miami, 2012). While the JHS has a number of different programs and facilities, it is important from the perspective of central management to understand the position that each has in the marketplace. JHS has a significant market share, as it is the largest hospital in Miami-Dade County. Its size and its mandate to serve the residents of the country regardless of ability to pay ensures a strong customer flow and substantial market share. The hospital's total revenue for the latest fiscal year was $4.8 billion, and on this it lost $34 million, an amount the county covers through a sales tax levy (Becker's, 2012).
Since 1993, the Truven Health 100 Top Hospitals program has used both independent and objective research to guide hospital and health system performance. In this process, they analyze public data sources to compare hospitals to similar organizations. The 100 Top Hospitals program uses a balanced scorecard that incorporates public data, proprietary, peer-reviewed methodology and key performance metrics to arrive at an objective, independent analysis of hospital or health system performance. This research measures performance, organizational alignment, progress
Hospitals in today’s world require organizations that have a variety of people on their boards. Hospitals are usually run by administrators, board of directors, and other departments. Each of the many tiers of the hospital organizations has varied goals and achievements that they wish to accomplish. This article is designed to discuss some of the strengths; weakness, opportunities and threats (SWOT) of the hospital organization (Roussel, 2013). Internal and external forces will be discussed as factors of influence upon the decision making body of the hospital. An example of a problem found in many hospitals, the threat of patient falls will be analyzed. This article hopes to give a better picture of hospital organizations,
HCA, after following a conservative financial policy since its establishment, has entered the new decade preparing to make some changes in order to realign their financial strategy and capital structure. Since establishment, HCA has often been used as a measure for the entire proprietary hospital industry. Is it now time for the market to realign their expectations for the industry as a whole? HCA has target goals which need to be met in order to accomplish milestones in the future. The problem arises as to which area holds priority to the company. HCA must decide how the key components of their financial strategy and policy should my approached in order
An organizational analysis is an important tool to become familiar with how medical businesses and organizations are able to meet standards of care, provide services for the community and provide employment to health care providers. There are many different aspects to evaluate in an organizational analysis. This paper will describe these many aspects and apply the categories to the University Medical Center (UMC) as the organization being analyzed.
Hospitals have organizational structures that allows them to carry out their duties efficiently and successfully. What separates the organizational structure of a healthcare organization from a business, essentially that the hospital 's organization is chiefly founded on the amalgamation of medical and administrative staff (Carayon, et al., 2014). The organizational structure of the twenty-first century solutions in health care hospitals involves, both divisional and hierarchical structure. In the of the chain of command hierarchy, there are various levels of professional’s that fall under other levels within the facility, and each staff member is organized in regards to departments that are related to their (KSA’s) skills, attributes and job duties (Carayon, et al., 2014). Hospital organization philosophies is based on development of values and ethics, with the understanding on moral principles relating to human conduct. These systems are comprised with the processes in decision making and determining the best actions to consider between the difficult alternatives when pertaining to patient care.