Nonprofit Hospital

Millions of dollars are spent on healthcare every year in USA but the health of the beneficiaries has not increased accordingly. Just providing healthcare is not enough; quality healthcare with long term benefits should be the aim of the healthcare providers. I have studied and worked in certain multi-specialty hospitals and government facilities in my home town. I have seen corruption and frauds happening at various levels and hence wanted to study about how such non profit and

The report provides a good data compilation, but provides little insight into the meaning of the data. Although the report provides little analysis, tax-exempt hospitals have provided significant amounts of financial assistance and other community benefits. [What remains to be seen, however, is whether insurance expansions under the ACA thereby decreasing pool of uninsured patients will cause these numbers to decrease in the future. Tax-exempt hospitals could further struggle to justify tax-exempt status.]

In 2012, the ACA found an excessive amount of readmissions of patients that were hospitalized within 30 days for the same medical conditions. This factor viewed under the ACA as a quality issue and CMS implemented value-based incentive payments based on performance in a set of quality measures. The plan is to implement a pay for performance (P4P) in formulas used by Medicare to reimbursement providers. “The objective is to link reimbursement to quality and efficiency as an incentive to improve the quality of health care, as well as reduce system-wide costs” (Shi and Singh, 2015). In addition to the P4P, nonprofit hospitals also focus on continual improvement, data and cost containment throughout the organization (Adamopoulos,

The purpose of this paper is to conduct a comparative analysis between for-profit hospitals and not-for-profit hospital. It will discuss the characteristics of each as well as factors affecting the operations of both systems. Additionally, it discusses potential areas of improvement and some of the challenges associated with each relative to finance and operations.

Nonprofit hospitals have become a common characteristic of the hospital sector because they can be found across the country because of their presence in almost every corner, they never decline to provide treatment, and offer several community-based health programs. On the contrary, the for-profit health facilities are regarded as the corporate model of health care services as they seek to make profit first. They enjoy huge capital that enables them to develop state-of-the-art facilities and purchase the latest clinical technologies.

The role of finance in Health Care Systems, Inc. as a regional not-for-profit hospital relates to both the accounting and financial management aspects of the business. Facets of both accounting and financial management are intertwined with maximizing productivity by way of managing and analyzing financial operations to ensure resources are being utilized properly (Gapensiki, 2013). The divulgence of financial reports to managers and investors will aid in the development of plans and budgets for future growth, assess acceptable levels of financial risk, manage contracts appropriately and make decisions related to capital investments allowing the organization to expand service offerings thereby demonstrating greater value in the community. Operating as a not-for-profit entity requires that the hospital operate exclusively in the interest of the public for a charitable purpose. Through understanding who the primary third party payers

According to the American Hospital Association the cost of equipment, services, and information services has risen drastically. A huge problem for hospitals now is that there has been an enormous increase in patients who have Medicare or Medicaid. The Hospital Association states that “60% of all admissions. Neither program fully reimburses the cost of hospital care.” Not only is the hospital not getting paid the full amount through the health insurance, but they have also seen a jump in people who do not have insurance and cannot pay for their hospital expenses this averages out to about six percent of hospital expenses. Hospitals must assume these costs as a part of their charity pay. These costs are then calculated and increase the costs of health care for people who pay for it, in order to cover these costs.

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

In other words, ever since the Affordable Care Act was passed, millions of Americans have insurance. This can be worrisome to non-profit hospitals due to the large number of patients. For example, there are far more patients than there are physicians, which causes the quality of care for these patients to diminish. Physicians cannot keep up with the amount of patients they need to see as well as give every patient 100% of their attention it is simply impossible. Therefore, hospitals may start to implement a policy where only certain insurances can be seen at the hospitals, excluding emergency situations of course, while others have to either see there primary doctors or specialists. In other words, physicians are discharging patients too early, which cause a large amount of them to be readmission. Therefore, this is costing the hospital millions of dollars as well as affecting the patients’ overall health. If there was a stricter policy on who can and cannot go to the hospital than patients may start to receive better care and non-profit hospitals can focus on their main mission and that is to treat the people of the community with a high and effective quality of

“The U.S. spends nearly twice as much money per capita on health care as other developed nations, yet the metrics show that Americans end up with worse care and poorer health.” (Hill) The rising cost of healthcare has pushed some non-profits to become for-profit organizations.

Next, we studied the financial structures of health care organizations. Specifically, we examined the structure of nonprofit healthcare organizations. I remember spending a good amount of time debating whether or not nonprofits should maintain their tax exempt status. As someone who had spent their entire professional career working for a nonprofit organization, I often viewed myself as the sole champion for these organizations. In sessions and on the discussion boards, I advocated that nonprofit healthcare organizations in most situation function as a safe net of the community and that the level of community benefits these organizations provide do justify the lost revenue for state and federal agencies.

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

Financing health services in the United States is very important and involves an excessive amount of health institutions and activities. Health services are supported by several methods to create revenue that most hospital, clinics, and treatment centers use for daily operational costs (World Health Organization, 2006). These methods are: general taxation of the state, county, or township/municipality, Medicare or Medicaid or other socialized health insurance plans, voluntary and private health insurance and lastly, donations to health charities accepted from non-profit organizations, donations

Non-Profit hospitals can often assist potential patients to care for the uninsured in their community (Kovner & Knickman, 2008).

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).