Reimbursement 2: A Case Study Of The Layoffs

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

After reading the case study it seems that one problem between the hospitals and upper management seems to be lack of communication. It seems that Singh and Mrs. Manzoni have not affectively communicated to the hospital administrators what the goals of the company are and what is best for the company. I believe that Mrs. Singh and the hospital administrators value the importance of two different things. Mrs. Singh values the importance of correct data entry into the firm’s management information system. While, the hospital administrators seem to be placing more value on the importance of patient services. In addition, it seems Mrs. Singh does not know what

In the healthcare environment, the challenges that providers face are revenue shortfalls due to insufficient payments from the reduction of Medicare reimbursement rates (Shi and Singh, 2015. p238). Payers that have employment-based insurance are charged extra to cover the remaining balance. This process is called cost shifting. In some healthcare systems, the relationship between reimbursement reduction and cost shifting is correlated in an inversely proportional trend. As the decrease in reimbursement from public insurance such as Medicare and Medicaid, the method of cost shifting would increase.

It is essential for an administrator to understand how private and government payers impact actual reimbursement. Government payers have a standardized benefit structure. The one benefit is that registration staff have an easier time calculating payment due (copayments) for service and can set up payment arrangements. Since the most significant proportion of funds coming into a healthcare organization is usually payments from third-party payers, therefore, it is critical to know how each reimbursement affect the others that come in. Healthcare organization may have hundreds of different payer’s relationships in the form of different contracts that have their own rates of payment that are usually different from other payers for an identical

Layoffs are not always the best solution for a decline in company profits. A business must resolve the conflict that exists between their responsibility to meet economic targets and the ethical responsibility of non-maleficence. Furthermore, it must be determined if the layoffs would even maximize stakeholder welfare from a utilitarian perspective (Arce & Xin Li, 2011).

Decrease in funding is another economic challenge in health care. The amount of finances coming from various sources not just the

Unit 2 AssignmentKelley WhitcombKaplan UniversityHI215-01: Reimbursement MethodologiesProfessor Kathleen SobelJuly 20, 2015Medicaid is one of the biggest insurance plans you can get in any state. In the state of Indiana, it is based off of your income. There is a certain amount (income) you have to make to determine if you will receive Medicaid or Healthy Indiana Plan (HIP). HIP is still a form of Medicaid, but you would have to pay monthly cost for it and have certain set of co-pays for certain services that is needed. HIP Plus is the recommended plan for members as it provides health coverage for a low, predictable monthly cost. HIP Plus also covers dental and vision services. If you do not pay your monthly payment you can be removed from

The hospitals inpatient visits vary from the routine to the most complicated IPPS, and it analyzes the historical costs of providing inpatient services for a diagnosis. Additionally, it sets the payment amount to treat the diagnosis in patients at different profiles like age, sex or complications. For instance, in 1983, Medicare applied historical information to introduce inpatient prospective payment systems with a basis on DRGs (Reimbursement Methodologies, 2016). When an inpatient facility submits a claim to a third-party payer under PPS, the application enters a diagnosis related group which determines the amount receivable by a hospital. Also, hospitals submit healthcare bills for each Medicare patient to Medicare Administrative Contractors (MAC), a private insurance company working in collaboration with Medicare to offer the programs’ operational functions. Therefore, MAC administers the funds while replacing previous fiscal intermediaries and Medicare

The organization depends on the Hospital Administrator to keep interaction with the community and relay solutions to any problems that may arise (Wolfe, 2013). The service of program development also impacts the hospital either positively or negatively. The organization depends on the administrator to keep ahead of development and always think outside the box for new innovative ideas from medical treatments all the way to managerial structure to improve the performance of the organization as a whole. Finally, the organization is dependent on all of its employees to function and is very dependent on the administrator not only to hire the best employees, but also retain the employees, and evaluate the employees as necessary to keep them functioning at their highest capacity (Wolfe, 2013).

The nurses, which have the highest turnover rate will be the on the top of the list, losing 40 employees in their department. It is a very demanding job, with high salaries, and perhaps the ones most subject to turnover. Also to mention, around 67% of the department received ratings of as either “low performance” or “meets the requirement.” Next on the chart, the Allied Health department will be losing 15 of their staff. It is due to the fact of the department’s high turnover rate and low performance appraisals. Next, on the Central Administration department, the layoff of 25 employees would be necessary in order to achieve a good deficit cut. In particular of this department, for the first time, the salary average will be taken into consideration. The department has one of the biggest salary averages of the hospital, which is around $40,000 per person. Also, since it is a hospital, the department is not “vital” for its existence. The doctors and nurses are the key members of a hospital and reducing administrative staff seems a good alternative in this situation. Next on the

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.

Challenges faced by HR management when significant staff cutbacks occur and how they should be addressed

Currently, nations are keen on cutting down costs, and to achieve this constant layoffs and hiring freezes are common practices. Although, this targets most professions, nursing forms the easiest target given that the profession is one of the largest budgets in the health care profession (Hendren, 2011). This creates fear among nurses and threatens their career as they have to struggle against the overwhelming wave of layoffs and job freezes. It is paramount that organizations get suppler with scheduling and staffing while coming up with innovative ways of reducing costs without compromising the quality of health care that patients get. These organizations should also adopt flexibility and change, which is a useful

Additionally, the unwillingness of the business office employees to accept onsite help from the hospital financial analyst team. They appear to be content with the status quo, which has resulted in their current financially precarious situation. They do not have the foundation needed, which should be as described by Weiss, Hassell, and Parks (2013) “…fertile enough to accept the seeds of change and to nurture them to grow” (p. 492).

Downsizing, restructuring, rightsizing, even a term as obscure as census readjustment has been used to describe the plague that has been affecting corporate America for years and has left many of its hardest working employees without work. In the year 2001 we had nearly 1.8 million jub cuts, that’s almost three times as much as the year 2000(Matthew Benz). In the 1990's, one million managers of American corporations with salaries over $40,000 also lost their jobs. In total, Fortune 500 companies have eliminated 4.4 million positions since 1979 including the 65,000 positions cut in February of 2002 (Ellen Florian). Although this downsizing of companies can have many reasons behind it and cannot be