Case Study: Baptist Memorial Healthcare

In mid-April 2000, Sherri Worth was faced with some very unsettling news about Pate Memorial Clinic’s future with a competitor potentially moving into the area. Worth was the assistant administrator at Pate Memorial Hospital (PMH) and was also responsible for the Pate Health Clinic (PHC). A study by the competitor was being done to see whether sufficient demand existed to establish a clinic 5 blocks north of PHC. The two biggest concerns in regards to the new competition were:

The North Texas State Hospital (NTSH) is part of the Department of State Health Services (DSHS) administration. NTSH is a mental healthcare facility that has two campuses: one department is located in Wichita Falls, TX and the other in Vernon, TX. Including both campuses DSHS is the largest mental hospital in the state of Texas, which provides psychiatric services for the mentally ill. NTSH is the only facility in the entire state of Texas that provides forensic psychiatric care. Forensic psychiatric care is a specialized service for prisoners who have mental disorders. NTSH offers a 284-bed maximum security program for adults and a 78-bed adolescent Forensic Program (DSHS Center, 2017). NTSH aims to improve the health, safety, and wellbeing of individuals by providing the right stewardship, reducing health care problems, improving public health awareness, and preventing diseases. In order to improve health and safety, NTSH is accredited by the Joint Commission on Accreditation of Healthcare Organizations. The Joint Commission is an independent, not for profit association that set standards to evaluate

This week I began my 6-week internship at Blue Cross Blue Shield of Nebraska (BCBSNE). The first day was a common orientation for all new employees, internally denoted to as the “onboarding process” where all employees are told they matter. This full-day session communicates the core mission, vision and goals of BCBSNE, organizational structure, operating objectives, and workplace culture. BCBSNE is a not-for-profit health insurance company that is focused on collaboration to find the best solution for their customers; in other words, they are customer-focused. Since the implementation of the Affordable Care Act (ACA), many changes to the health insurance market required a change in the organizational structure and culture of BCBSNE. Through partnerships with providers, the goals of BCBSNE are to be responsive, accountable, minimize errors, and decrease costs – all components of the ACA. BCBSNE has strategically aligned their goals to those of the government-mandated goals, and implemented them at all levels of the organization, making them competitive in the health insurance market. I found this very fascinating: I was very excited after day one!

On October 10, 2015, while working off duty at Cardinal Health, reserved Deputy Brawley and Sergeant JakeBowden were advised by an employee that a wrecker was circling the lot. It is Cardinal Health’s policy not to allow people on the property unless they have business with or are employed by Cardinal Health. The parking lot is posted.

Jones Regional Medical Center is a huge academic health center with 900 beds and are known for its research and teaching hospitals. Additionally, the IT staff at Jones supports 300 applications and 12,000 workstations. The center uses Technology Med (TechMed) for their admitting system. The system includes registration, inpatient charge, payment entry, master patient index, admission, hospital billing, and more. The TechMed system has been accessible since 1998; Jones is beginning to plan a replacement of this systems because of the fragility of the software (Wager, 2013).

APS Supervisor Matthew Mitchell made face to face contact with Mr. Charles Hamilton at the Intermediate Care Unit of Walker Baptist Medical Center on 7/17/15 at roughly 10:30 AM. Before visiting with Mr. Hamilton in his room, Mitchell spoke with Ginger Kilgore, RN Case Manager, in her office. She stated that Mr. Hamilton was ready for discharge. She admitted that the hospital was aware Mr. Hamilton’s home in Carbon Hill was currently without electricity and water, but that no alternative placement could be found, nor would Mr. Hamilton agree to discharge anywhere but his residence. Ms. Kilgore also mentioned that Dr. Claude Osula admitted Mr. Hamilton into their care a few days ago due to low potassium levels. He noted in his discharge summary

The Basic Health program could be structure in several ways. It could expand programs such as Medicaid and CHIP and contract with managed care plans on behalf of its Medicaid and CHIP beneficiaries outside the private insurance market. These changes would allow both programs to continue as a "separate program with a separate financing mechanism and risk pool from that of Medicaid and CHIP, but would leverage the state's existing infrastructure for information technology, contracting, rate setting, and other function" (Angeles, 2012). Alternatively, a state could expand the Medicaid managed care by increasing the number and types of service through different network of providers, other than those that serve Medicaid and CHIP beneficiaries (Angeles,

Tulsa Memorial Hospital (TMH) is one of the nine acute care hospitals that serves in the general population area. Historically, it has been highly profitable due to its well-appointed facilities, excellent medical staff, good-standing reputation for quality care and its ability to give individual attention for each of its patients. The hospital, in addition to its inpatient services, operates an emergency department and an urgent care center located two miles from the hospital across the street from a major shopping mall.

West Florida Regional Medical Center (WFRMC) located on the north side of Pensacola, Florida competed strongly with sacred heart and Baptist hospitals for patients. WFRMC’s CEO John Kausch was an active member of the Total Quality Council of the Pensacola Area Chamber of Commerce (PATQC) (McLaughlin, C.P., Johnson, J.K., & Sollecito, 2012).. PATQC’s vision was to develop the Pensacola, Florida area into a total quality community by promoting productivity, quality and economic developments in all area organizations both public and private (McLaughlin, et, al., 2012). John

QMHP called the client to informed her that she is not eligible for case management due to (1) living in Independence and (1) has inactive Medicaid. QMHP informed Ms. Anderson that she could receive services at Swope as an outpatient. Ms. Anderson asked if she could get her medications and other services (Imani House, vision, dental) without having Medicaid. QMHP told Ms. Anderson that she could. Ms. Anderson stated she will apply for her Medicaid. QMHP apologized to Ms. Anderson two times because at the intake, QMHP had informed Ms. Anderson that he was eligible for CSS. QMHP told Ms. Anderson that after she her Medicaid is active, she could request for a CSS. QMHP thanked Ms. Anderson for her understanding and hang up the

The Alabama Medicaid Agency received your request for Administrative Review on June 4, 2015. This request is being denied, because it was received more than 60 days after the limit for requesting the Administrative Review which was March 6, 2015.

Arrowhead Regional Medical Center (ARMC) is a 456-bed teaching hospital located in Colton California. Out of the 456 beds, 90 beds are behavioral health and 366 are inpatient hospital beds. ARMC is a comprehensive inpatient and outpatient health care facility providing multitude of care including: primary care, specialty care, trauma care and houses the only burn center for four counties. Moreover, ARMC has 9 residency programs which are accredited by ACGME and AOA, both are known entities in graduate medical education. Furthermore, Arrowhead Regional Medical Center’s Ambulatory department operates over 40 specialty clinics and 4 family health clinics. Three of the family health clinics are off site located in Fontana, Rialto and San Bernardino. ARMC covers about 98% of Medi-Cal patients through the coverage plan of IEHP and Molina.

It was in 1977 that the United Healthcare United Health group was founded by Richard Burke. The headquarters of the company are in Minnetonka, Minnesota. This organization works towards the betterment of people's health, it help them in living a healthy life by providing them with the kind of health care that would be best for them. The main focus of United Healthcare which is a major division of the United Health group is to provide the people with better health benefits and coverage.

Columbus Regional Health (n.d.) serves 10 counties in Southeast Indiana. The demographics include a predominantly Caucasian population of approximately 300,000 people (Economic Opportunities through Education by 2015, n.d.). In southeastern Indiana, about 140,000 individuals have employment, and 15% of them, who are over the age of 24, have a bachelor’s degree (Economic Opportunities through Education by 2015, n.d.). Approximately 30% of the high-school students drop out in this mainly rural area with a flat population growth (Economic Opportunities through Education by 2015, n.d.).

Background - The Arnold Palmer Hospital is 1 158-bed paediatric hospital located in Orlando, Florida; part of the Arnold Palmer Medical Foundation and rated as one of the nation's Top paediatric hospitals by U.S. News and World Report. It is the only hospital in all of central Florida with an emergency/trauma center dedicated specifically to pediatric patients. It opened in 1989, and in 2006 became a children's hospital focused solely on