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Evaluation and Implementation for Improvement

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Submitted By tatachv
Words 1078
Pages 5
To: Board of Directors of Middlefield Hospital
From: Vitalina Tatach
Date: August 15, 2015
Re: Evaluation and Recommendations for Improvement

I have been diligently working on reassessing our present situation with loss of revenue and other bellow described weakness. After thoroughly studying past years’ reports, I came up with a few thoughts that I would like to share with you which should make positive income and decline out quality assurance problems. With that in mind, I came up with few suggestions on how we could fix and strengthen our present weaknesses with revenue, marketing and managed care.
Payer Mix Problems Our healthcare facility has been losing money for the last few months on Medicaid and Medicare patients since the enactment of Affordable Healthcare Act. The government is paying less and less for the services that are being provided to our patients and also is very slow at paying claims, however more and more patients are being added to the program which is the result of why Medicaid performed worse than commercial plans and Medicare on key metrics such as days in accounts receivable, denial rates and electronic remittance advice transparency. While some state Medicaid plans, such as Medicaid Connecticut, performed especially well on select metrics, such as enrollment, as a whole the category continues to underperform. (Monegain, 2014) Middlefield Hospital is a community based hospital and in this way, it constantly does its part at being a fundamental piece of its group. Our patients with commercial insurance payers have significantly declined because of the poor economy. Nonetheless, our healthcare facility is still one of the best in the area, because the quality has always been our first priority.

My first proposal would be to recommend a "healthcare exchange." The healthcare exchange is, in actuality, a market place in which

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