Massachusetts General Hospital: Cabg Surgery (a) Essay

Consequently, it become a financial problem where physician sees no improvement in their revenue/profit, and the cost of treatments continue to rise as reimbursement challenges the physician’s charges. There is always a cost to a better health care and coverage, and vast of it comes from taxation. Hospital and physicians function on funding to keep the door open and operating, and majority of the funding are from taxation. For

The Iron triangle for healthcare consists of cost, quality, and access; these three characteristics when balanced create great healthcare. Managed Care Organizations combine the three to offer consumers with care that is appropriate for their individual needs. Our book describes managed care organizations as “the cost management of healthcare services by controlling who the consumer sees and how much the service cost” (Basics of the U.S Healthcare System, Niles). Taking a look at the history prior to the Health Maintenance Organization Act of 1973 (HMO ACT of 1973) the implementation has been significant in balancing cost, and quality control. Before this Act was signed in to law by President Nixon healthcare costs were determined by fee for service. A fee for service or indemnity plan is a plan that allows the provider to determine the cost of service, this fee for service plan caused for healthcare costs to increase rapidly. An example of this would be going to the doctor with neck pain, being told to stretch then receiving a bill for 25,000 dollars. As could be understood the cost of healthcare had became a problem.

“VH must find a best solution on controlling its medical equipment maintenance costs, improving operation efficiency, reducing the operating total costs, thus, making the most of the government funds in order to improve patients’ satisfaction?

RECOMMENDATION  There is “an inherent conflict between best care and financial performance”. The CEO states that “Finances are not, and never have been, our primary concern.” However, the business must address its decreasing profitability to be able to continue to survive. This will become even more urgent if the reduced government spending that the CEO foresees happens.  The organizational culture is high quality care, high-performance and non-profit which must be taken into account in any solution. The healthcare business has a clear focus and is very successful at continually improving its patient care and processes.  While clinical performance improvements have resulted in revenue losses for the Intermountain healthcare business the Intermountain health plan, SelectHealth, and other health plans that buy Intermountain health care services have benefitted. Intermountain needs to translate these benefits into additional profits to support its main business, healthcare.   Its skill at providing this care should translate into significant market advantage for SelectHealth and for Intermountain when selling

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

On the same level from a patient’s perspective, providers are even challenged with increased costs. Even though insurance is becoming more affordable the money, unfortunately has to be recovered utilizing other

As discussed previously, the Affordable Care Act of 2010 passed by the legislature, drastically changed the entire healthcare economy. In fact, ever since the ACA was passed it was required by law for hospitals to increase the amount of attention given to the individuals of the community in order to meet their needs. Also, the ACA allowed close to 10 million individuals to have health insurance through Medicaid and private health insurances, which has a high impact on all the hospitals, such as Yale New Haven. For example, since millions of Americans can now afford health insurance, there is a large influx of patients who can go to hospitals and actually afford the overall cost. The non-profit hospital of Yale New Haven is benefiting in two ways. First, they are achieving their mission by caring for the individuals of their community who now have insurance and secondly, they are being compensated in terms of revenue to improve their organization in regards to hiring the greatest physicians and having the best technology and supplies to treat their large influx of patients (Cunningham, 2015). The rise in health insurances increases the total amount of money earned by that non-profit organization and the amount of patients receiving great quality of care.

The healthcare system in America started as a predominantly volunteer system where patients were required to pay little to nothing for treatment. Since it began, the healthcare industry has seen tremendous changes that have transformed it into a business entity which has operations like financial management, strategic planning and functional specialties to keep the industry viable. The industry is one of the largest in the country employing 15 million people with a projected increase of jobs with 3 million jobs annually. As the healthcare industry continues growing, services and personnel are changing, and various dynamics are coming into play to accommodate changes (Smith, Saunders, Stuckhardt, & McGinnis, 2013).

Since most specialty procedures are inpatient services, EMC’s inpatient occupancy rate suffers. The occupancy rate for Emanuel Medical Center – fifty percent – is far below that of its competitors and industry benchmarks. To accompany this, EMC (on average) receives a lower reimbursement for in-patient Medicare services per patient seen in comparison to its competitors. A result such as this is correlated with directly to the fewer amount of specialty services that EMC offers. In order for Emanuel Medical Center to be able to compete with other hospitals in its service area, it is imperative that EMC evaluates what services they currently offer and are capable to offer in the future to add value to the hospital, increase its revenue stream, and expand its patient mix. Currently, Emanuel Medical Center has not succumbed to its increasing financial pressurealthough EMC has had a negative operating income for five straight years. A negative operating income places EMC at a disadvantage because it limits the hospitals ability to renovate its aging building or hire new specialists to offer revenue enhancing procedures. EMC’s competitors, on the other hand, have large sources of revenue due to their mergers with large healthcare networks such as Catholic Healthcare West. Another competitor, Kaiser Permanente Modesto Medical Center, has extremely large financial resources due to the fact

According to Ingols and Brem (as cited in Swayne, Duncan, and Ginter, 2006), Massachusetts is known across the world for computer technology, education, and health care. In the words of the authors, Massachusetts' "health care expenditures per capita were between 27 and 29 percent higher than the national average from 1990 to 2000." At the time, there was a general consensus that Boston's health care was relatively expensive as a result of the region's cutting edge and high quality services (Ingols and Brem, 2006). During the 1990s, a number of healthcare insurance plans at the national level chose to merge in an attempt to further enhance their ability to compete effectively. This trend according to Ingols and Brem (as cited in Swayne, Duncan, and Ginter, 2006) was also replicated in Massachusetts where the eventual formation of three large competitors had far-reaching consequences. One consequence of the increasing power of these three formations in the marketplace was reduced payments.

The equipment in the hospital needs to be replaced and was 20 years old. Pemiscot’s primary care providers see patients by offering sliding scale rates however the medicines are not being covered in this method and hence the sick population is not buying any and is getting sicker.as the hospital is mainly serving an agricultural county, which ranks as one of the worst in health indicators, many of the patients are uninsured and hence they have to treat the patient if they turn up at the ED but won’t get compensated (Doyle. 2015). The main conditions identified were high smoking rates, diabetes premature deaths and poor quality of life. Closing the hospital is therefore not an option (PT Community,2017). The lack of doctors in the area forces the others to treat other specialty conditions as well. Many doctors are frustrated with the lack of compliance to their instructions. (Doyle,

In the Harvard Business School case study of Intermountain Health Care (IHC), we learned about the efforts made by IHC to adopt a new strategy for managing health care delivery that is focused on improving care quality while simultaneously saving money. Beginning in 1986 as a series of experiments tying cost outcomes to traditional clinical trials, IHC’s approach to delivering care became known as “Clinical Integration” which “referred to both an organizational structure and a set of tools” (Bohmer, 2002). The organizational structure required a departure from the traditional administrative management model to one that “involved administrative and medical

The cost of the health care industry has always been rising since the early 1980s. It has been a growing concern in both the industry and society. Massachusetts General Hospital (MGH) is no exception. Even though the average length of stay (LOS) for the patients in MGH has been declining (Exhibit 10), it is still the highest compared to their competitors (Exhibit 6). Besides the cost, there is no uniformity of process and standardization across different facilities and departments of the hospital. MGH lacks communication and coordination between the facilities.

Hospitals and health systems in the U.S. are experiencing a remarkable transformation in their business models directed from numerous influences that are projected to ultimately turn the industry around. Pressures include providers troubled with the quantity of services they are responsible for, to providers who concentrate on presenting high-cost services that give emphasis to sustaining healthy populations (Dunn & Becker, 2013).

The significance of community hospitals such as Community Hospital in Monmouth County, New Jersey, is greater than one may expect for primary and secondary care services provided to the local communities around the United States. Community Hospital’s mission is to provide exceptional primary care. However, with the declination of profitability in primary care, Community Hospital has had to compete with Shore University Medical Center (SUMC) and University Hospital (UH) for revenue restoration. The decline of Medicare and Medicaid reimbursements and the steady progression toward specialty care vs. primary care require a core alteration to the mission statement to adjust to the changes within the current healthcare system. A newly modified mission and vision statement will prove that Community Hospital has the ability to regain its relevance within the healthcare industry as a leading primary care provider in the community and increase its revenue. The implementation of the new mission and vision for Community Hospital is expected to be upheld without compromising the core values of compassion, advancement, reputation, efficiency, and physician integration. A few proposed strategies to help Community Hospital create a new and improved business model, may seem cumbersome and challenging, however could greatly improve the overall direction of Community Hospital.