Background In order to understand financial statements better, two healthcare organizations, one for-profit and the other non-profit, will be selected and their financial statement will be reviewed. The first healthcare organization that was selected was Adeptus Health, Inc. (Adeptus), a for-profit entity. Adeptus was founded in 2002, and currently serves communities in Colorado, Texas, and Arizona, with partnerships within Ohio and Louisiana (Adeptus, 2016). The company was founded to improve services within the emergency room (ER) setting by offering the community eighty-one free standing ERs and two ER facilities within a fully licensed hospital, as of the end of 2015 (Adeptus, 2016). Adeptus boasts being one of the best companies to work for in Texas in 2016, and has won the Press Ganey Guardian of Excellence Award for three consecutive years, since 2013, which is awarded to ERs that exceed patient satisfaction over the ninety-five percentile across the country (Adeptus, 2016). The company aspires to provide high-quality care that is patient-centered while being cost effective and supportive to their staff. The company saw opportunity in investing into quality ER care as demand rose at the same time as ERs decreased. The business built free standing ERs within areas that were underserved and had a need for better quality of care (Adeptus, 2016). With the passage of the Affordable Care Act (ACA), Adeptus found opportunity in providing patient-based, quality care at a
This is an opportunity for hospitals to work more closely with skilled nursing facilities and other post-acute providers to improve care transitions, and experience fewer readmissions. The ACA impacted hospitals by holding back a one percent reimbursement rate. Hospitals will actually need to perform and deliver high-quality evidenced based care to recover the one percent withheld reimbursement rate while hospitals that exceed the benchmark, will received a higher reimbursement rate over the one percent. The Act is intended to help spur the trend of more integrated care throughout the continuum. The Affordable care act (ACA) of 2010 designed programs for improvements and innovation in the quality of hospital care by instituting the Medicare’s hospital readmission reduction program. Through this program, CMS reduces Medicare payment bt one percent for hospitals for hospitals that demonstrated high rate of avoidable readmissions for patients with a diagnosis of heart failure, heart attack
External and internal influences are relevant in health care. These influences continue to affect the total operations of a health care facility. I will summarize the insights I have gained into the external influences of the new health care reform policy and quality initiatives. The recent health care reform legislation was passed in the house and senate this year. The senior vice president, that I have interviewed, states that health care reform is an “unknown” for organizations. In addition, I will research the quality improvement initiatives and how these external influences include implications for organizations and health care administrators.
Our healthcare system is in a state of constant change. Just as the industry was adapting to the demands of countless healthcare reforms, the fate of regulations like the Affordable Care Act (ACA) and others like it, dangle in the wind. As the country transitions to a newly appointed administration, there is an increasing level of uncertainty among industry leaders. Federal, state, and local mandates continue to drive the need to improve the quality, costs, and outcomes of care which add to an already overburdened and burnout system. These coupled with our highly secular society who is primarily focused on the treating and curing illness through advanced technology, medications, and procedures has resulted in a
(MCOs) operating. The hospital group is the state’s largest not-for-profit organization and boasts an impressive performance plan, serving the healthcare needs of approximately 8 million citizens in Virginia. Moreover, Chesapeake Health Plans was the first organization to successfully attempt to request and obtain the highest level of accreditation from the National Committee of Quality Assurance (NCQA). Furthermore, Chesapeake health plans are structured to provide medical plans that cover services under the HMO’s, PPO’s, POS, and Medicare HMO’s. Chesapeake health plans attributes a considerable portion of their net service revenue generated to their effective HMO health plans, which realized a 46% of total revenue, while their Medicare HMO produced an impressive 39% of total revenue. Furthermore, their Preferred Provider Plan (PPO) generated 10%, and the Point of Service Plan (POS) saw a 5% figure. This case study financial analysis will effectively assess Chesapeake Health Plans: HMO financial performance, focusing on a competitive analysis, a cash flow analysis, clear profitability ratios, liquidity ratios, debt management ratios, asset management ratios, operating indicator analysis, a comprehensive financial assessment of Chesapeake’s financial state, as well as effective fiscal recommendations for their organization.
The Obamacare/ACA, might have helped numerous of individuals in acquiring health care, but the health professionals are facing a shortage of reimbursement difference for their services. As a result, Hospitals and healthcare providers were force to layoff personal and come up with innovative solutions. This point is proven by the renowned author, Amy Anderson by stating as follows: “The American health care framework has had shortages of personnel for quite some time and would not be prepared to give the adequate service to this amount of patients in need of medical attention. Training new professional health services personnel could take years. There is a shortage of graduates from medical and nursing schools. Doctors, nurses and health professional are sharing responsibilities prospective patients will face a longer wait time”. (Anderson, 2014)
Jim James, the CEO of _______, when faced with the reality of the Affordable Care Act (ACA) becoming law and taking effect, began to implement new rules and guidelines for his institution. Although improvising a strategic plan the institution is expected to follow as supplies and resources would soon be in critical demand. As CEO, he understood what was expected of the health care system, focusing mainly on the organizational needs that will help with the expanding or growing population and meeting the increased demand for the future. Via industrialized existing programs and building clinics that will accommodate the expected significant impact of the newly insured. “Eliminating ED crowding will take the collective involvement of healthcare workers, business leaders, politicians, the press, and the public” (Derlet & Richards, 2008). After much consideration, and a comprehensive evaluation of the documents for the new Affordable Care Act Jim James thought about the upcoming opportunities using a persuasive approach to transform the hospital. Since he stated that his most pressing desire is to find ways to connect the recipients in a way that will model changes in existing programs. Admittedly, we have a medical, acute care, care system- a system that waits until we become ill before it kicks into action instead of a healthcare system focused on helping us stay healthy (Schimpff, 2012). The justification, seeing the possibilities that are crucial in dealing with changes in
In the hope of better coordinating the care of patients, improving quality and lowering costs, the ACA provides incentives for physicians and hospitals to work together in several ways, such as Accountable Care Organizations (ACO’s) or establishing bundled payments for episodes of care (Martin Gaynor, 2012 ) which has spurred consolidation (Becker, Gamble, & Rosin, 2015). Additionally, compliance with various federal programs such as Meaningful Use requires a significant investment in technology which can be fiscally challenging for smaller provider groups; driving acquisitions of these smaller entities by larger health systems. Other reasons cited by hospital administrators in the pursuit of consolidation is to ensure a steady stream of physician referrals (NPR, 2010), and to create economies of scale and increased efficiencies, the fruits of which result in reduced costs and therefore cheaper care for patients (ProMarket Writers, 2016). However, what most hospital
When faced with the reality of the Affordable Care Act (ACA) becoming law and taking effect, Jim began to implement new rules and guidelines. Although impravision a strategic plan the institution is expected to follow as supplies and resources would soon be in critical demand. As CEO, he understood what was expected of the health care system, focusing mainly on the organizational needs that will help with the expanding or the growing populationu8, meeting the increased demand for the future. Via industrialized existing programs and building clinics that will accommodate the expected significant impact of the newly insured. “Eliminating ED crowding will take the collective involvement of healthcare workers, business leaders, politicians, the press, and the public” (Derlet & Richards, 2008). After much consideration, and a comprehensive evaluation of the documents for the new Affordable Care Act, Jim James, CEO thought about the upcoming opportunities using a persuasive approach to transform the hospital. Since he stated that his most pressing desire is to find ways to connect the recipients in a way that will model changes in existing programs. Admittinly, we have a medical (that is, sick) care system- a system that waits until we become ill before it kicks into action instead of a healthcare system focused on helping us stay healthy (Schimpff, 2012). The justification, seeing the possibilities that crucial in dealing with changes in the upcoming health care system using a
Quality of care is a primary article of the ACA and a major goal is to insure every American has exactly that. Even though the “care” pillar is the strongest of the three pillars it still faces many challenges. One major component defining quality of care is technology. The medical community currently suffers from outdated technology, which leads to lapses in care and lack of communication between medical facilities and companies causing overlap and delay. Better technology is required to expedite file distribution between medical facilities and help share patient information between pharmacists and physicians. This, of course, is expensive and like other aspects of this bill is falling short in funding and again driving another nail into the potential Obama care coffin. More troubling, perhaps, is the massive costs of maintaining and operating the countries medical infrastructure. Its figured that the combination of hospitals, physicians, insurance companies, and the federal Centers for Medicare & Medicaid Services are projected to total almost $2.7 trillion between 2014 and 2022. If Americans are to receive actual quality care, then financial burdens must be solved before any real progress can be
The health care industry is one of the most dynamic and delicate industries in the U.S. having experienced healthy and substantial changes for the last thirty years most of which have aimed to improve health care management and services delivery to the patients. The changes have enabled the integration of technology into the industry such as in the area of informatics, science and research and payment services and clinical treatments. The health care sector has introduced various changes to address disease and health care management such as the Modernization Act of 2003, the Patient Protection Act and Affordable Act, which aim at improving health provision and most
Thus, a challenging task hospital administrators must overcome is determining how to align financial incentives to match quality measures in the ER. On the opposing end, insurance companies have already begun creating a financial incentive for patients to stop visiting the ED. A study by the NEHI (2010) found that increasing the co-payments associated with ED visits will significantly reduce ED usage. The NEHI (2010) states increasing the co-payment for these visits up to $50-$100 has decreased the ED use by 23 percent. Indubitably, costs of care will continue to be a driving force of decisions regarding the ED in every component of the health care
The intention of this research paper is to further understand the financial statement of four distinct hospitals located in the San Diego, California County. An analysis of the financial report for Sharp HealthCare, Scripps Health, Tri-City HealthCare, and Palomar Health will be briefly discussed individually on each important financial outcome’s Such as: assets, liabilities, revenue, expenses, hospital debt, and investments. To analyze further, a break down between the hospitals assets, liabilities, and revenue will be compared in the paper.
The Affordable Care Act puts consumers back in charge of their health care. Under the law, a new “Patient’s Bill of Rights” gives the American people the stability and flexibility they need to make informed choices about their health. The Patient Protection and Affordable Care Act (PPACA) is a multi-faceted reform of the nation 's health care system. The Wow Hospital Association is working with members, stakeholders and lawmakers to facilitate implementation of the law. Wow Hospitals will experience as a result of the ACA. Common themes in all of these reforms are accountability, efficiency, and quality. Furthermore, these plans provide new opportunities for WH to invest in upstream interventions– working to make policy, systems and environment improvements that will impact the communities in which we serve.
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).
One of the most important profitability metrics is return on equity. Return on equity reveals how much profit a company earned in comparison to the total amount of shareholder equity. It’s what the shareholders “own”. A business that has a high return on equity is more likely to be one that is capable of generating cash internally. For the most part, the higher a company’s return on equity compared to its industry, the better.