RW Healthcare

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Question Description

ALL PARTS HAVE TO BE COMPLETED, DO NOT COMMIT IF YOU ARE NOT GOING TO COMPLETE ALL PARTS

Part 1

Scenario (400-600 words)

Established in 1977, Krona Community Hospital is a 60-bed, acute care hospital located in the heart of Banconota County. With a staff of nearly 100 physicians and specialists, 400 employees and 75 volunteers, they offer a full range of health care services. They are accredited by The Joint Commission.

Nouveau Health, a private, not-for-profit health care chain, took over management Krona Hospital. Last year, state officials began to discuss Nouveau’s proposal to build a new, replacement hospital in Banconota County. The new facility would have 74 acute care beds, four observation rooms, four surgical operating rooms, one c-section room, a 24-hour emergency department, a maternity center, an intensive care unit, and an extensive outpatient center that will provide service such as diabetes treatment, physical therapy, speech pathology, and so forth.

You are a staff member in the finance department at Nouveau Health, whose sole responsibility is to advance the success of the organization through assisting in planning, forecasting, and finance management.

Primary Task Response: A wellness program includes services with exercise programs and chronic disease management to catch problems early so that a customer can be seen in urgent care or a doctor’s office instead of ending up in the hospital. It increases outpatient revenue and decreases inpatient admissions and readmissions thereby, hopefully, decreasing risk for financial loss. Familiarize yourself with an example of a wellness center at the following web site:

http://www.sw.org/location/waco-getterman-wellness-center 

Based on Krona’s budget, consider the effects that a Wellness Program provides to Krona. If the wellness program is to include outpatient revenue, home health revenue, and pharmacy revenue, discuss how outpatient and inpatient revenue will differ with these budgetary goals. Include the following:

  • What has to occur for inpatient revenue to increase?
  • How do readmission rates affect inpatient revenue?
  • How do outpatient services increase reimbursement in a Wellness Center?
  • How can expenses be controlled to improve revenue?

Part 2

Primary Task Response: Within the Discussion Board area, write 400–600 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas.

Due to decreased funding caused by value based models of payment, accountable care organization payment and bundled care payment, discuss the following:

  • What is the impact that these new payment models will have on Krona’s revenue.
  • Address the possible issues surrounding next year’s forecasting.
  • Discuss the challenges, benefits, and risks in utilizing capitation.

Part 3

Within the Discussion Board area, write 400–600 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas.

There are very few industries that have the unique economic factor in which the majority of its revenue does not come directly from the customer, but from a third party. This unique economic factor is usually referred to as a private health care insurance company. Third party payers are the commercial, governmental, and health care maintenance insurance companies that help providers manage its patient’s accounts. With the change in focus toward the patient as consumer and increasing number of health plans that are high deductible, patients are becoming more involved in deciding where they go for their healthcare needs.

To increase referrals, Krona is beginning to develop a new marketing campaign to target a new patient mix and increase revenues, something that you discussed in your last Individual Project. You have been asked by the chief financial officer (CFO) to collaborate with the marketing director and discuss the importance of having advertising materials for both the health insurance companies and the patients who receive the health care services.

  • List 3 marketing approaches you would use to target potential patients and health care insurance companies.
  • Explain what factors you used in choosing your specific marketing strategies and the purpose of each selection..
  • How should the hospital market their commitment to patients while considering valued based programs, accountable care organizations and bundled payments? 

    Some marketing strategies may include the following: 

    o Social Media
    o Television/Radio
    o Telemarketing
    o Direct Marketing to customers and referrals

Part 4

Using the budget information from Part 1 discuss the need for the following:

  • Increase in revenue reimbursement through inpatient length of stay and outpatient vendor relationships
  • Allocation for the proposed improvements and required partnerships
  • Partnering with local skilled nursing facilities and home health organizations
  • Increase in salaries

Be sure to discuss the following areas:

  • Funding sources
  • Your methodology in revenue forecasting
  • How the new services will impact revenue?
  • Fixed and variable costs
  • Project inpatient and outpatient visits based on current trends

Part 5 (400-600 words)

You are a staff member in the finance department at Nouveau Health, whose sole responsibility is to advance the success of the organization through assisting in planning, forecasting, and finance management. The chief executive officer (CEO) of Krona has asked that you complete the following:

  • Explain how revenue cycle influences the building of the new hospital
  • Discuss why increased outpatient services will be required to improve revenue in a bundled care, accountable care, valued based environment
  • Discuss 3 ethical concerns in the new billing environment

Part 6

Within the Discussion Board area, write 400–600 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas.

No other country in the world has a health care system like that of the United States. For this Discussion Board assignment, complete the following:

  • Choose a developed country and discuss how its model of health care (e.g., national health insurance, national health system, or socialized health insurance) differs from that of the United States.
  • Discuss some of the strengths and weaknesses of that model in comparison to what is offered in the United States.

Part 7

Within the Discussion Board area, write 400–600 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas.

Public and private health insurance plays a very significant role in the delivery and funding or reimbursement of health care services, making it very important that all health care professionals understand, at a minimum, the basics of health insurance. For this assignment, you are required to discuss the following:

  • Provide a definition of both private and public health insurance, and discuss the differences between private and public health insurance.
  • Choose 1 public health insurance program (e.g., Medicare, Medicaid, or Children’s Health Insurance Program), and discuss the basics of that program and the financial impact it has had on health care delivery in the United States.

Part 8 (400-600 words)

Technology in health care has made it possible for patients to use devices to access their medical information, monitor vital signs, take tests at home, and carry out a plethora of other tasks that could only previously be conducted inside the doctor’s office (Topol, 2013). This enhanced technology is one of the many reasons that there has been a shift from inpatient to outpatient care. Although patients have benefited greatly from health care technology, there are also downsides to technology, such as how it has affected the cost of care. For this Discussion Board assignment, you should complete the following:

  • Provide a definition of outpatient care.
  • Discuss 2–3 ways in which technological innovations have impacted, or will impact, the delivery of care in the United States.
  • Discuss 2–3 ways in which technology has had, or is expected to have, a detrimental impact on the delivery of care.

The use of at least 2 scholarly references is required.

Part 9

Within the Discussion Board area, write 400–600 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas.

In most other countries in the world, government plays a central role in covering health care needs; however, in the United States, the private sector (in the form of employer-sponsored health insurance) serves as the dominant form of medical coverage. For this assignment, discuss the following:

  • Describe and discuss some of the ethical concerns or problems that exist because of the dominant form of employer-sponsored health insurance.
  • Discuss reform actions that the U.S. government has taken to reduce the ethical concerns or problems that you discussed.
  • Define the ethical principle of justice, and discuss its role in the U.S. health care system.

Part 10

Review and reflect on the knowledge you have gained from this course. Based on your review and reflection, write at least 200-300 words on the following:

  • What were the most compelling topics learned in this course?
  • How did participating in discussions help your understanding of the subject matter? Is anything still unclear that could be clarified?
  • What approaches could have yielded additional valuable information?
  • The main post should include at least 1 reference to research sources, and all sources should be cited using APA format.

Part 11 (3-4 pages, not including a title and a reference page, and a minimum of 3 references)

This Individual Project will be a foundation for the other Individual Projects in this course. You will use the work in Unit 1-4 IPs as a final project to be submitted in Week 5 as a formal Plan for a healthcare facility.

Health care in the United States is changing. A paradigm shift is occurring as more and more health care organizations are reorganizing existing business models from inpatient to outpatient services. That being said, you have been tasked to develop a proposal for the development of a health care facility that is designed to meet the rapidly changing health care needs. Within your proposal, you are required to research and discuss the following:

  • The type of facility you are recommending and the rationale behind your recommendation. For example, if you chose an ambulatory care facility, explain the reasons why this type of facility would be recommended over another type.
  • The type of health care delivery and services that are provided at the facility.
  • The type of staff that will work in the facility. Specify the position categories and/or titles for these positions and include what are the credentials or licensures required by these positions in the state in which you live where you proposed facility would be located.

Note: You should include a minimum of 3 references, properly cited in APA format.

Part 12 (3-4 pages, not including a title and a reference page, and a minimum of 3 references)

“The complexity of financing in health care is one of the primary characteristics of medical care delivery in the United States” (Shi & Singh, 2012, p. 129). There are numerous reimbursement methods (e.g., capitation, fee-for-service, package pricing, etc.) that are used by health care organizations and providers to get paid for the health care services that they provide. Building upon your Individual Project from Unit 1, write a 3-5 page paper not including a title page and reference page that contains the following:

Summarize 3 different reimbursement methods that are used by health care providers and organizations.

Choose which method(s) will work best for the health care facility that you have proposed to be developed, and explain why you chose that method(s).

Discuss the pros and cons of the reimbursement method(s) that you chose.

Discuss the impact that the method(s) may have on the financial operations of the facility that you chose.

Note: You should include a minimum of 3 references, properly cited in APA format.

Part 13 (3-4 pages, not including a title and a reference page, and a minimum of 3 references)

The use of health information technology (HIT) has increased dramatically over the past decade, resulting in the federal government enacting several pieces of legislation such as the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009. Continuing to build on your proposal for a healthcare facility from Weeks 1 and 2, you are assigned to research and discuss the following:

  • Discuss the financial and health benefits that can be realized by implementing an electronic health record (EHR).
  • Research and explain the estimated cost of implementing an EHR and the estimated cost of managing an EHR over the long run.
  • Discuss current security concerns surrounding HIT and the EHR.
  • Discuss how electronic health records can be used for decision-making and problem-solving.
  • Choose 1 piece of federal legislation (e.g., HIPAA, HITECH Act, Meaningful Use), and discuss the requirements that legislation imposes on the use of HIT and the EHR.

Note: You must use at least 3 scholarly references.

Part 14 (3-4 pages, not including a title and a reference page, and a minimum of 3 references)

Building on your Weeks 1 through 3, you must now identify and discuss some of the legal and ethical considerations that must be taken into account in constructing your proposed healthcare facility. You are required to include the following:

  • Define and discuss the differences between licensure, certification, and accreditation as they relate to health care facilities.
  • Discuss the ethical or legal requirements and responsibilities that a health care organization has in ensuring its facility is licensed, certified, and accredited. When discussing licensure requirements, ensure that you research requirements based on the state in which you reside.
  • Define and discuss the differences between the licensure and certification as they relate to healthcare providers or professionals.
  • Discuss the ethical or legal requirements and responsibilities that a health care organization has in ensuring its staff members are licensed and certified.
  • Research and discuss an accrediting body that will provide accreditation to the facility you are proposing. Ensure that you provide a history of the organization, what types of facilities they accredit, and how the organization has impacted the quality of health care in the United States.

Note: You must include a minimum of 3 scholarly references.

Part 15 (Part 1: 2 pages of new content for a final 7-10 page plan for healthcare facility; Part 2: 1-page re)

In this assignment you will finalize your plan for the proposed healthcare facility by incorporating your work from Weeks 1 through 4 along with new content as described below Combine the work that you did in Units 1-4 IP to construct your final plan and add the addition content on Quality as described below. Your final paper should be 7-10 pages including the two new pages of content from your research on quality this week. This assignment has two parts:

  • Plan for your proposed healthcare facility
  • Reflection on what you have accomplished in completing your course of student by your work in this capstone course and what skills you will continue to develop and improve on as you begin or advance in your career in healthcare management.

Part 1: Plan for proposed healthcare facility

You have been asked to present your plan for the proposed health care facility to the Board of Directors. Based on your previous assignments, you are to develop a proposal as a written paper that includes the following:

  • The type of health care facility (Week 1)
    • Discuss the type of facility that you are recommending and the rationale behind your recommendation. For example, if you chose an ambulatory care facility, explain the reasons why this type of facility would be recommended over another type.
    • Discuss the type of health care delivery and services that are provided at the facility.
    • Discuss the type of staff that will work in the facility. Specify the position categories and/or titles for these positions and include what are the credentials or licensures required by these positions in the state in which you live where you proposed facility would be located.
  • Financing the organization (Week 2)
    • Discuss the method(s) of reimbursement that you believe will work best for the health care facility that you have proposed to be developed, and explain why you chose that method.
    • Discuss the pros and cons of the reimbursement method(s) you chose.
    • Discuss the impact that the method(s) may have on the financial operations of the facility that you chose.
  • Medical technology (Week 3)
    • Discuss the financial and health benefits that can be realized by implementing an electronic health record (EHR).
    • Discuss the estimated cost of implementing an EHR and the estimated cost of managing an EHR over the long run.
    • Discuss current security concerns surrounding health information technology (HIT) and the EHR.
    • Discuss how electronic health records can be used for decision-making and problem-solving.
    • Choose 1 piece of federal legislation, e.g., HIPAA, HITECH Act, Meaningful Use), and discuss the requirements that legislation imposes on the use of HIT and the EHR.
  • Ethical and legal considerations (Week 4)
    • Discuss an accrediting body that will provide accreditation to the facility you are proposing.
    • Discuss the ethical or legal requirements and responsibilities that a health care organization has in ensuring that its facility is licensed, certified, and accredited. When discussing licensure requirements, ensure that you research requirements based on the state in which you reside.
    • When discussing licensure requirements, ensure that you research requirements based on the state in which you reside.
  • Quality measures (Week 5) (This will be a new section as part of your project)
    • Research and describe at least 2 measures that you plan to use in your facility that are currently used to gauge quality in health care.
    • Identify how data for these measures will be collected and analyzed.
    • Set realistic benchmarks for each proposed measurement, and explain the rationale behind the benchmarks that you set.

Note: You should include a minimum of 3 references with the new content for Week 5 combined with the references used for the work done in Units 1-4.

  • All sources should be cited using APA format.
  • Grammar, spelling, punctuation, and format should be correct and professional.

Part 2: Reflection on what you have learned and what you will work on to continue to develop as a healthcare management professional. Write a 1 page reflection on the following:

  • As you complete the course and your degree program and look forward to advancing your career in healthcare management, what are the skills and competencies that you feel you have developed and what are the ones that you will need to continue to work on? How do you plan to improve upon your skills and continue to develop competencies in healthcare management?

    The American College of Healthcare Management provides resources related to the competencies that healthcare management professionals should possess