Medicare
Scenario
Throughout this course, you will provide information and analysis using a fictitious community hospital, Healing Hands, located in a suburban community about 15 miles outside of a major metropolitan area. Each week, you will complete specific assignments, and in the final weeks of this course, you will provide a final report detailing your findings.
The following scenario will be utilized throughout this course to assist you in completing each week’s assignment:
Healing Hands Hospital is an acute care community hospital in a suburb 15 miles outside of a large metropolitan city. The hospital, which was founded over 50 years ago, is dedicated to serving the local community consisting of working professionals, families and retired individuals. It has 320 beds and is comprised of a group of 500 physicians. The hospital has in-patient services for short-stay acute care patients; an in-patient mental health unit; an ambulatory surgical clinic; and specialized units in cancer, maternal and child services, orthopedics, and cardiac care. Healing Hands Hospital serves a community of approximately 500,000.
Mr. Jeff Magone, the new Chief Executive Officer of Healing Hands Hospital recognizes that an important trend in healthcare delivery that is linked to reimbursement is accountable care and integrated delivery models. He has set the goal for the hospital to remain financially viable and increase services and quality of care available to the community served by Healing Hands Hospital. To accomplish this goal, Mr. Magone realizes that there are several options to consider such as:
Addition of outpatient services including urgent care centers and affiliations with more local physician practices,
Merging with another community hospital in a neighboring suburb, or
Affiliating with one of the two large academic medical centers in the city.
Mr. Magone and the hospital Board of Directors have discussed the options and they realize that some changes need to be made to not only maintain and improve the high quality of patient care for which Healing Hands is recognized but also to ensure future financial stability in the changing healthcare industry.
Mr. Magone and the Healing Hands Hospital Board of Directors have created a “Future of Healing Hands” Task Force, and as a Director of Operations, you have been asked to participate on the Task Force and provide support through research, analysis and reports to the Task Force as they evaluate options to meet the goals outlined by Mr. Magone. You will work with your supervisor, the Chief Operating Officer, Ms. Woods, as well as the Chief Financial Officer, Mr. Johnson, and provide research and analysis. Community leaders will also be part of the Task Force providing recommendations and input from the community served by Healing Hands Hospital. Mr. Magone realizes that developing outpatient services, urgent care clinics, affiliations with medical practices or merging with an academic medical center will also require upgrades to the electronic health record system (EHRs) and other computer systems. Therefore you will also work with the hospital’s Chief Information Officer to determine if current systems such as the EHRs and Clinical Decision Support Systems are scalable or need to be replaced.
Mr. Magone has made it clear that patient needs and future financial stability are driving the project. He wants to ensure that Healing Hands Hospital stays current with reimbursement and quality care models and remains financially sound through reimbursement by Medicare and other health insurance plans. Leadership at Healing Hands also recognizes that strong relations with the community and the Healing Hands staff will be imperative to success.
Throughout this course, you will research and analyze different aspects of the developing strategic plan for this initiative. Each week, you will build the information needed for the plan, and in the final weeks of this course, you will provide a final report detailing your findings.
Your final report to the Future of Healing Hands Task Force will include the following components :
Week 1: Legislative and regulatory requirements for Medicare reimbursement including changes for physician practices related to MACRA
Week 2: Difference between provider organizations, Healing Hands and an academic medical center, in terms of mission, services, organization structure, etc.
Week 3: Reimbursement models including managed care and changes to Medicare reimbursement models
Week 4: Impact of advances in health information technology on operations and reimbursement.
Week 5: Complete Final Report of findings from each section (week) to the Task Force with the inclusion of research and analysis of healthcare quality metrics and impact on budget and reimbursement.
Continue to use the scenario to assist you with this assignment.
Healing Hands Hospital is an acute care community hospital that serves a suburban community outside of a large city with two competing large academic medical centers. Both Healing Hands Hospital and the academic medical centers have a long history of service to the region, but their business and fundamental practices are different. Your manager, Ms. Woods, Healing Hands’ Chief Operating Officer, is part of the Task Force working on the strategic plan for the hospital and needs to understand the fundamental practices of these academic medical centers.
You have been asked to research the differences between the services that your organization offers and those of at least one of these academic medical centers. For the purposes of this assignment, use the Web to research community hospitals and academic medical centers and select one community hospital and one academic medical center located in the same city or area to represent these two healthcare organizations for the purpose of working on this assignment. You will use the information that you find about these two healthcare organizations for the Individual Project assignments in the remaining weeks of the course culminating in your final project in Week 5. Use the acute-care community hospital to represent Healing Hands Hospital. This link provides a list of example community hospitals. Choose one and then find an academic medical center located in the same geographic region. Review the Web information on these facilities to complete this assignment.
1. Describe the similarities and differences of these organizations in terms of the following:
Mission
Goals
Objectives
Management structure
Reimbursement models
Staffing
Policies
Procedures
Research and clinical trials
2. Based on your analysis of the data that you present, provide your opinion on what would be the main areas of concern if the two organizations were to merge and how they could be overcome.
You may include a table for the comparison data, but you must describe your evaluation of where there are and are not similarities between the two healthcare organizations and your opinion.
Be sure to document your references using APA format. This includes the websites for the two hospitals that you are using for the assignment.
Reference:
100 Great community Hospitals (2016). Becker’s Hospital Review. Retrieved from http://www.beckershospitalreview.com/lists/100-great-community-hospitals-2016.html
Please submit your assignment.
For assistance with your assignment, please use your text, Web resources, and all course materials.
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