Healthcare Costing Strategies

The health plan rate has been increasing at least 20% each year and has added significantly to the hospital’s operational cost. We will also create questionnaires and perform surveys and inform our employees of our financial issues and why the health plan needs to be restructured with marginally higher co-pays, prescription costs, and deductibles. The results of this information will shared with hospital staff to determine health plan will offer the best solution for our organization.

According to Yoder-Wise, (2015), healthcare organizations are service institutions, and the largest part of their operating budget typically is for personnel. Therefore, staffing and supply management are areas that are affected in cost management. The knowledge of fixed cost such as rental fee, salaries, and variable cost such as supplies and medication is essential in the allocation of funds for cost effective operations. All these aspects of budgets are interrelated with a goal of maintaining cost effective budget for each unit.

Becoming more efficient: Healthcare reform and all its provisions are already helping hospitals find new methods to broaden facility efficiency, better control care and streamline charges. One object is renovating hospitals to diminish on operating charges. Clinic executives allocated 21% of their budget to renovations compared to 16% for brand development in 2012 consistent with an ASHE 2012 survey. A further approach is enforcing new applications comparable to what Seton family of Hospitals did after they enacted a nurse call center which on a monthly average dropped emergency room trips by 12.1%.

I agree with your analysis of what makes strategic planning relevant. Since the implementation of the Affordable Care Act, strategic planning is a vital factor in organizational focus, and stakeholder commitment as you made mention. The healthcare strategic model used by Zuckerman is a great demonstration of how planning has evolved within healthcare. The chaos of new policies such as the ACA combined with a dynamic environment of practitioner shortages is why planning is applicable today. I also agree that organization performance can be vague in terms of a strategic plan. The reason, I believe for this, is healthcare as a business has a financial bottom line perspective; whereas, a nonprofit healthcare organization has a double bottom line

Speaking of reimbursements, health care organizations should implement strategies to overcome financial outlooks. Core competencies such as type of governance, coding compliance, consumerism, unnecessary variations, and patient-centered care are becoming the new norm for health care

An Accountable Care Organization (ACO) is a system of doctors and hospitals that divide financial and medical responsibility for providing corresponding care to patients, in hopes of regulating unnecessary spending. The goal is to change the way hospitals, physicians, and other care providers are paid in order to emphasize higher quality at lower costs. The idea of ACOs is that by working together, a group of providers can deliver care of equal or better quality while reducing the cost. In most health care systems, a fee-for-service payment system is used. Doctors and hospitals are normally paid for each procedure and test. Consequently, rewarding providers for doing more, even when it isn’t

As a warden, to lower medical costs at my facility, instead of focusing on diagnostic care, I would implement a preventative system as well as education for inmates regarding medical issues. Research indicates that prisoners are only treated for ailments when they are reported and because of this, some inmates may not report illnesses or some illnesses may go undetected.

Healthcare costs in the United States are on a continual rise with no relief on the horizon. As the population ages and lifestyles differ from one individual to the next, healthcare third party payers such as commercial insurance plans, employee health benefit plans, the Medicare program and state Medicaid programs are searching for strategies to lower the costs associated with providing healthcare benefits to their beneficiaries. Disease management programs are emerging as a way to help decrease the high cost of health care typically associated with chronic illness by coordinating care between the patient and their

Managed care was established in order to manage health care cost, utilization, and quality (Kongstvedt, 2015). In managed care, health insurance is provided through HMO, PPO, and other types of managed care. It has the potential to reduced health care spending and improved the quality of care. However, despite of its success in improving the quality of care through preventive health care services, chronic disease management program, and so forth, many physicians are reluctant to be part of the managed care environment. Some of the reasons are the impact of managed care to physician’s income and autonomy. Under managed care, insurers have decreased the fees paid to physicians. There are different ways how managed care organizations control costs. One of this is through selective contracting with health care providers and hospitals to lower costs. In selective contracting, health care providers agreed to accept lower prices in exchanged for guaranteed volume of patients under managed care plan (Culyer, 2014). This paper will discuss more issues and trends in Managed Care Organizations such as the rise of Medicaid Managed Care spending, the new Medicaid Managed care Rule, and the collaboration of Managed Care Organizations and Accountable Care Organizations to reduce health care spending and improve efficiency of care.

bSociety today has made great strides in terms of healthcare today. Life expectancy in most of the human population today is at its highest, and many of the diseases that had ravaged human society before had become manageable because of medical breakthroughs that had started a few generations ago. This is not to say that there isn’t anything left to do, however. Far from it. There is still much left to be done in the healthcare industry, as old problems still float while new ones arise to the surface.

What distinguished very competitive markets (those with below average profit margins) from less competitive markets (those with average profit margins)? Healthcare managers must understand the structure of private and social insurance programs because much of their organizations’ revenues will be shaped by these programs. Managers must be aware that consumers ultimately pay for healthcare products, a key fact obscured by the complex structure of the U.S. healthcare financing system. Substantial numbers of healthcare mangers serve firms that seek to maximize profits. For an example, for-profit hospitals, most insurance companies, and a broad range of other organizations explicitly seek maximum profits. Many not-for profit healthcare organization

For several decades health care has been tied to the economy and with the current downturn we see continued efforts to control and reduce over-head costs. Health care organizations in their effort to become more efficient and address changes in the industry have altered their strategic business plans. Lee & Alexander (1999) researched organizational change in hospitals and their survival, in this paper I hope to discuss their findings and add other examples to validate their conclusions.

Kaiser is able to respond to the challenges set forth because they continue to evaluate what changes need to be made and how to make them successfully. The strategic plan allows for an overview of where the facility is currently standing. This allows for any changes that are made internally or externally to be evaluated at the time of the change instead of after the change has been made and it is too late. The strategic plan helps to have a faster response time because there is already plan in place so it is easier to see where the changes are made and how to correct them without the facility suffering.

For health care administrators the biggest issue is the constant changing of the everything health care. The heath care field is always improving with new technology developing. These new developments are increasing the costs of health care as well. After Medicaid and Medicare was brought about the health care spending increased as it gave more access to those in need of health care. Higher spending however did not result in higher quality of care, greater access, improved health outcomes or higher patient satisfaction (Shi & Singh 2015). There has been a lot of back and forth on the way Medicare is changing the way it will pay for hospitals such as the hospital readmissions reduction program. Which reduces the cost of patients when they are

Improving efficiency can make inpatient care more cost-effective, but primarily it helps improve the quality of that care. Clinical policies and protocols give physicians standards by which to assess the efficiency of the care they provide. For a complex case, one physician should act as “commander,” and doctors covering on weekends should be empowered to discharge.