Healthcare And Physician Joint Ventures: A Case Study

The strategies that can be used are an increase in Chief Executive Officer (CEO) involvement, compelling marketing material, technology, financial incentives, and the execution of the job offer (Cohn & Harlow, 2009). CEO involvement is a large component to recruiting and retaining the physicians that will be employed within the Pocahontas community. This is because the physicians that are being recruited see the accountability of the leadership team to ensure their advancement and compensation within the organization (Cohn & Harlow,). This accountability ensures that the leadership of the organization is in-sync allowing for a better work place, and ensures the organization is invested in their

With any form of integrated physician model both parties have much to gain, patient acquisition, quality of care, and resources are some examples that both parties could see as incentives to work together. Treatment is being shifted from volume of care to quality of care since the incorporation of the affordable care act set

As you are well aware of, how patient care is delivered is ever-changing in the healthcare world in which we live in. Since the passing of the Affordable Care Act or “Obamacare” in March of 2010 the world of healthcare that we know has drastically changed. In 2011 the U.S. Department of Health and Human Services (HHS) developed new rules under “Obamacare”, aimed at helping doctors, hospitals and other provider’s better coordinate care by implementing Accountable Care Organizations, or ACOs Leavitt Partners has been actively tracking ACOs since 2010 and the number of current ACO’s in the United States as of January 2015 is 744. According to the Leavitt Partners survey, over 23.5 million people are being covered under one of the ACO models (Health Affairs Blog, 2015). According to these statistics and growing number of hospitals participating in ACOs, where is does your hospitals potential financial performance stand if it were to become part of an Accountable Care Organization (ACO)?

ACOs can be classified into six categories based on the number and leadership structure of parties involved in the ACO, the services provided directly by the ACO, and the services provided through contracted entities (see Table 1). ACOs can range from an “Independent Physician Group” that only directly provides outpatient care, to a larger, “Full-Spectrum Integrated” ACO that directly provides all core medical services, from ambulatory to inpatient and to post-acute settings. Using this taxonomy to identify different ACO types can help providers learn from like-entities by distinguishing structural commonalities between different organizations, and by highlighting common approaches to managing patient care. Further research using this taxonomy can also help ACOs and researchers’ alike better understand performance to date of these different accountable care arrangements and the factors most critical for success.

Accountable Care Organizations (ACOs) like any other organization need funding. Organizations cannot function without financing. They must be funded in some way to continue operation to support employees and practice. ACOs can be funded in two different ways, internally or externally. This means funding is coming from the organization itself or from an outside investment.

Physicians play a crucial part in this partnership because they are accountable for directing clinical services, determining the appropriate care for the patients; performing procedures, and determine when to use medications or medical supplies. Healthcare organizations have transitioned to models of physician integration

The American health care system has been victim to an escalation in the prices of health care services juxtaposed with inefficiency in delivery of care services. There has even been cases where State spending on the actual health care increased dramatically in the United States and one of the key components of curbing this problem which has been prevalent over the mass media and has been a major discussion among physicians is the advent of Accountable Care Organizations. Accountable Care Organizations (ACOs) is structured with the goal of trying to improve health care delivery and aid in the reduction of the overall cost of services (Weissert & Weissert, 2012). If there is insufficient coordination of high quality care delivery in the health care industry, this will have a negative impact on patient safety and diminish affordable care for patients. Hence, the development of ACOs is envisioned to be the savior of medical practices and can improve the overall fabric of the American society (Bresnick, 2013). ACOs serves as one of the answers for curbing the problem of high costs, low quality care and possible segmented delivery and as much as it serve as the major determinant for improvement in patient satisfaction, there are minor

Since the passing of the Affordable Care Act (ACA) in 2010, the healthcare revenue cycle has significantly change. Physicians and managed care organization saw a spike in the number of patients. iThe health care also law created initiatives to transition from the traditional fee-for-service (FFS) system to a payment-for-value delivery system, with key attention to cost containment and quality improvement. Managed care organizations are restructuring how they deliver care and receive reimbursement in a value-based system to maximize their profit.

Over the course of a few years, hospitals and physicians will form a series of partnerships (Harrison, 2016). The series of partnerships is known as an integrated physician model. The integrated physician model is important in healthcare because it allows the organization that is following it to

package to attract physicians, and then offer partnership or ownership equity as an additional incentive for loyal, productive service. Furthermore, many managed care organizations and other institutions offer clinical opportunities and growth in such areas as utilization management, total quality management, disease management, and population health programs. Teaching and research institutions are offer wide-ranging and often unique opportunities that let physicians expand their professional limits. And lastly, medical staff for federal, state, county, and city agencies, are all some of the major financial and motivational force for physicians.

In examining the most important characteristics of various types of provider organizations, in terms of mission, goals, objectives, staffing requirements, policies and procedures, I first needed to determine; what is considered an organization health care provider? I found a fact sheet present by the Center for Medicare and Medicaid Services, which identify organization health care providers as “hospitals, home health agencies, clinics, nursing homes, ambulance companies, and health care companies formed by individuals,” as organization providers (National Provider Identifier, 2007). One common thread that all of these organizations have is the identifier standards, developed by the Secretary of Health and Human Services and followed under the Health Insurance Portability and Accountability Act of 1996 (HIPPA). This standards dictates that: “all covered entities under HIPPA are required by regulation to use NPI’s (National Provider Identifier), to identify health care providers in standard HIPPA transactions” (National Provider Identifier, 2007). These organizations may contain sub-units, such as laboratory, pharmacy, or rehab services, and these units may require their own NPI for standards related to those units (National Provider Identifier, 2007). However there are other characteristics and external interventions in which these providers rely on in contemporary healthcare, in order to obtain accountability and value in their delivery of healthcare.

In years past, the hospital experience has been a big issue when it comes to the quality of healthcare. Most hospitals that don’t meet national standards included lengthy stays, several misjudgments and holes in prevention control. In general they have lacked patient respect, according to medical historians and health care professionals. However, these issues have improved substantially over the years. Because of cultural shifts, policy adjustments, healthcare prices, and technological advances, hospitals have moved toward a more patient based approach that emphasizes the importance of prioritizing prevention in all cases. Patient satisfaction is now a priority in healthcare nationally.

Accountable Care Organizations (ACOs) is defined improve health care quality and reduce health care costs by getting providers to work together and focus on the quality of care, not the quantity, the health care providers and coordinator an example possibly including doctors, hospitals, health plans and other health care constituents, Medicare payments beneficiary using the service set the organization and sharing and saving certain percent varies by payers, together to provide coordinated high quality care to populations of patients.

Strategic Planning: Due to the current issues, both internally and externally, the organization is facing, Dr. Townsend is challenged to prepare an action plan to implement the proposed strategy needed to restore the organization back to financial health and improve the morale among the physicians and support staff. Another course of planning Dr. Townsend will challenge is the organizations old structure into a way that all patients will be satisfied.

Factors that raised concern included the fact that the general hospital was not profitable and that the competition included three large providers with unlimited resources. Being in this situation, management must have understood that their organization was in need of a change, and needed to differentiate themselves from the competition. With this, they then conducted a market analysis to better understand to the community needs, the competition, and future demands of the immediate market area. In doing so, they were able to find that they were