...art of principled compromise. This report is part of a series commissioned by the BPC to advance the substantive work of the Leaders’ Project on the State of American Health Care. It is intended to explore policy trade-offs and analyze the major decisions involved in improving health care delivery, and discuss them in the broader context of health reform. It does not necessarily reflect the views or opinions of Senators Baker, Daschle, and Dole or the BPC’s Board of Directors. The Leaders’ Project was launched in March 2008. Co-Directed by Mark B. McClellan and Chris Jennings, its mission is (1) to create a bipartisan plan for health reform that can be used to transform the U.S. health care system, and (2) to demonstrate that health reform is an achievable political reality. Over the course of the project, Senators Baker, Daschle, and Dole hosted public policy forums across the country, and orchestrated a targeted outreach campaign to Members of Congress, the Administration, and key health care constituencies. In June 2009, they released the Project’s final report entitled, Crossing Our Lines: Working Together to Reform the U.S. Health System, which includes a slate of comprehensive policy recommendations to address the delivery, cost, coverage, and financing challenges facing the nation’s health system. For more...
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...Introduction United States has one of the highest GDP among developed nations yet it fails to deliver a widespread and affordable health care to its citizens. Will health care reform be able to deliver quality services at affordable cost with its existing workforce crisis in the healthcare system? Number of uninsured Americans has significantly increased, mainly due to aging population and income change. The prevalent issue of America’s healthcare system is insurance coverage, access to healthcare. Americans believe this issue should be prioritized, and it is the direct responsibility of federal government to ensure medical care for those citizens that lack insurance. This essay include history of United States healthcare system, its evolution and how healthcare providers can contain costs of healthcare and provide quality and access to healthcare for everyone. From the beginning of 2014 Affordable Care Act by Obama government is trying to solve the enduring issue of American healthcare system. It is a step in the right direction but this reform is facing lots of resistance from Republican Party, that this reform will put country in debt stress. Many Americans are concerned with quality and access to healthcare with the influx in number of insured entering the healthcare system which is already facing the workforce crisis. United States Health care History Healthcare in United States is enduring issue and it is very sensitive subjects for Americans. United states...
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...clients and patients. Financial reporting provides documentation, records, and an understanding of the inflow and outflow of capital within the healthcare facility, and shows rather a profit or loss is being made within the organization. According to Baker, J.J., and Baker, R.W. (2011). Healthcare Finance: Basic Tools for Nonfinancial Managers, through the four elements of financial management: planning, organizing and directing, controlling, and decision making healthcare organizations can increase revenue, lower expenses, and become leading healthcare providers by achieving their financial goals. Yet, when an organization fails to use ethical financial reporting practices, and the four elements of financial management than it becomes endanger of collapsing. The two articles that I will highlight in this paper will assist in explaining both the effects of successful financial reporting practices, and those of poor reporting practices. In the article, New White Paper Details Impact of Health Reform on Critical Revenue Cycle Issues (2013), the successful use of the financial management elements planning, organizing...
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...Planning in an Era of Health Care Reform Strategic Planning in an Era Of Health Care Reform ‘Volume to Value’ Abstract The White House and the current administration of President Obama made the passage of Health Care Reform a top priority and signed the bill into law March 23, 2010. There are two laws that make up the reform package; the first is the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act. Critics both in support and opponents claim the bills do little to alter healthcare inflation or uneven delivery of care (Ferman, 2010). The goal of the bill is to change a volume based model in to a value based business model. A comment by Moody’s Investor services exclaimed that the reform will undoubtedly require healthcare leaders to focus even more on multi-year strategies to ensure long term financial stability (Kim, Majka, & Sussman, 2011). Leaders will have to establish a long range plan that includes financial projections and goals, long range capital expenditure requirements, debt capacity, capital position analysis, capital shortfall analysis and sensitivity and risk analysis (Kim, Majka, & Sussman, 2011). There will be substantial increases in the number of newly insured that will place a tremendous amount of stress and unknown consequences on an already burdened healthcare infrastructure (Tyson, 2010). The objective of this paper will attempt to examine the implications of reform on strategic planning of health...
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...The Impact of Healthcare reforms on Hospital Costing Systems The costing systems implemented in hospitals has been the same for a while now. It’s worked and has been easily allocated based off of averages from previous years. Now as times change so will the costing systems for hospitals in order to get the most beneficial cost-reductions to them as well as improve on efficiency. This article looks into how accountants for hospitals can redesign, reposition, and re-implement costing ideas to allocate on a per-unit of care basis (Selivanoff, 2011). We’ll take a look at two ways for accountants to prepare for these reforms and five steps to adjusting the costing systems in place. In the hospital costing system accountants want to measure costs during a patients stay to determine how much resources are being used. The one way accounting departments are improving efficiency is deter away from the average costs for their resources. Rather than allocating a hundred dollars for this test and a hundred dollars for this procedure they want to implement an “on-the-fly” care plan. Which measures truly how much a patient is costing them to get the optimized cost-reduced methods. It allows them to take a deeper look into inventory and assign costs to each resource so that patients really pay for what they used and hospitals have a clear costing method that’s equal for every person. This method is effective but is highly stressful for the accounting department to record at first...
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...International Journal of Public and Private Healthcare Management and Economics, 1(2), 17-25, April-June 2011 17 The Politics of Health Finance Reform in Hong Kong Raymond K. H. Chan, City University of Hong Kong, Hong Kong ABSTRACT Since the late 1950s, Hong Kong’s public health services have increased. They are mainly funded by taxes, supplemented by minimal user fees. In the late 1980s, the government recognized the limitations of this financing model and subsequently proposed alternative methods of funding. Their proposals have been rejected by various stakeholders, who represented different, and even conflicting, values and interests. This paper describes the development of health services and the debates that have surrounded health financing since the late 1980s. It shows that the health finance debate in Hong Kong is not a simple issue that can be tackled by rational planning; instead, it is a complex consequence of welfare politics in an increasingly mobilized society. Keywords: Health Finance, Health Policy, Health Services, Hong Kong, Public Health Services INTRODUCTION The earliest public health services in Hong Kong were mainly devoted to combating communicable diseases. As the government was largely unresponsive to demands for further services, the gap in provision was filled by traditional Chinese medical practitioners and hospitals operated by local philanthropic organizations. It was not until the late 1950s that the government expanded its role...
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...Patient Protection and Affordable Care Act (PPACA) is one of the most substantial reforms in Medicare since 1965. This is now considered the law of the land according to Douglas Holtz-Eaton. The PPACA portrays a “coverage first” strategy. “Sadly, a review a of the state’s experience bodes poorly for the future of national reform.” (Point/Counterpoint 177) There are two major driving factors in which could propose a threat for this reform. The first factor is it costs too much. Many decades ago, healthcare spending was at a minimum and not the focal point of American citizens. The statics show during 1970, national health expenditures were $1,300 per person and consumed 7 cents out of every national dollar, 7% of the GDP. Since the 1970, the spending per person has grown 2% more each year than income per captia. Therefore, healthcare costs have been increasing at such a high rate and will continue to threaten many decades to come. The second factor is the skyrocket of health insurance. This obviously is not mindboggling due to the fact that it is a reaction to the rapid increase of healthcare. Insurance costs have tripled over the past decade, making it hard for the average citizen to afford such outrageous premiums. As a result, less and less people are opting out of health insurance, which is no longer an option due to the new federal law making health insurance mandatory. The PPACA reform is looked upon with a “cost first” approach. This approach allows quality care...
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...countries outrank the U.S. in quality and access of care. Before the Affordable Care Act came along, many individuals and families would forgo purchasing insurance premiums due to the high costs and only utilize emergency rooms when in need of care. Health care reform ideally will address the millions who are without health insurance and provide a higher standard quality of care. The reform of the health insurance system aims to reduce national spending by making changes to the law to incentivize health care providers and organizations to reduce unnecessary spending and focus on increasing access to meet the new demand of the newly insured. Profit vs. Non-Profit Consider for a moment that the majority of health services spending is done by non-profits. These same non-profit organizations are now held to a higher standard, specifically, what exactly they are doing to serve the underserved in their local markets. Recent healthcare reform is a mixed blessing for non-profit and for profit hospitals. Over 30 million Americans previously uninsured Americans will now have the ability to pay for preventative care and check ups and stay visit the emergency room less often. This upside for both profit and non-profit hospitals creates a greater customer base and fewer uncollectible services. However, there are new limits on certain charges and Medicare reimbursements are now tied to performance levels. Healthcare organizations (HCOs) are increasingly responsible for the...
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...target and priority. As a developing nation, we cannot ignore this new phenomenon that is bound to raise the stakes in the delivery of our health care services. e-Health is many things; it is accessing electronic clinical information at a click of a button, it is being able to refer a patient to another hospital for diagnosis and treatment without him having to be there physically, it is also described as the use of using electronic and portable gadgets like phones to collect data as in a field study thereby efficiently connecting different departments in a hospital for a seamless flow of information, it is developing and creating software that will promote health in the industry…it is many things. Beyond our borders, other countries are proving to be a step ahead in terms of e-health. They have openly accepted ICT in their health industries providing a strong foundation for e-health growth. Rwanda, Uganda and Tanzania are good examples of countries that are already on the map for extensive e-health reforms. We are lagging due to the many bureaucracies involved in transforming our industries. The reluctance to adopt change also weighs down heavily on our reform agendas especially in issues pertaining to health. However the twin ministries of Health in Kenya have taken a bold step forward in this area by establishing an eHealth Division headed by Dr. Esther Arthur-Ogara, to spearhead the use of ICT in our health sector. e-health...
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...The Newton-Wellesley Hospital (NWH) is a medical center that provides the services and expertise of a major medical facility with the convenience and personal attention of a community hospital. NWH is committed to delivering high-quality safe and efficient medical care to each and every patient. As Vice President for Physician Services, it is my position to display leadership within the NWH family. To work closely with the Chief Operating Officer (COO) and other members of NWH’s team to ensure hospital-related practices. This position serves for an excellent leadership opportunity and to help CEO, Dr. Jellinek to develop a plan of actions that are of priority for Newton-Wellesley Hospital for the next six months. My position is to identify the major issues and to execute a plan of action to solve these issues. Six Month Plan of Action Priority Issue: Shifting workforce demographics Both the influx of women and the new generation of young physicians’ shifts have a significant implication for recruitment and retention because of assumptions regarding the younger generations and women’s attitudes towards work and patient care (Jovic, Wallce, & Lemaire, 2006). This poses a problem because many of the younger physicians have a desire for more flexible schedules, a preference for the latest technology, and generation X and women are more concerned about work-life balance and quality of life rather than the older generation of physicians. The profession of medicine...
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...indicators at the lowest level compared with other countries at a comparable level of development (World Bank, 2004). In this period, communist party who have the whip hand support the model of the 20th century communism ideology, and trust people should to be represented by the government, should have all production together: without the private department. Formation of the Chinese healthcare system. Therefore, since 1949, the Chinese government has gradually established a free medical care, labor insurance and cooperative medical care system as the main content of the health care system, and initially formed a socialist country's health care system. The government owned, funded, and ran all health care facilities, including large hospitals in urban areas and small township clinics in the countryside. All providers were employees of the state. Meanwhile, private health practice and private ownership of health facilities disappeared along with other private business. Development of Chinese healthcare system In 1950, at the First National Health Work Conference, the central government announced four fundamental principles for medical and health work: service for workers, peasants,...
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...lever by which central governments can influence the success of the domestic economy is by ensuring its public sector operates efficiently. The central governments of the developed economies have adopted similar change agendas to transform their public sectors. These change agendas entail the introduction of new structures, new kinds of organizations and a ‘reinvention’ of many parts of the public sector. The intention of successive governments has been the creation of a ‘New Public Sector’, which is more strategic and corporate in its thinking. This ‘New Public Sector’ is intended to replace a public sector characterized by bureaucracy, professionalism and departmentalism. In this paper we take a specific look at the National Offender Management Service (NOMS) from an accounting perspective to shed light on the influence and changes involved of defining something as an accounting entity. We will look closer at and critically evaluate the issues involved in the representation of NOMS as an accounting entity. Furthermore, we will analyze the implications of the representation of NOMS as an accounting entity on definitions of organizational accountability. Therefore, we look in a next step which aspects of NOMS’ accountability are highlighted in the Accounts and what aspects are left out? Finally we examine what issues, items and risks are kept “off-balance sheet”? And what might be consequences of this. According to Hendrikson (1970) defining something as an accounting entity...
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...coverage in the United States has been a forefront issue. With the overwhelming amount of uninsured Americans and the past unsuccessful efforts of health care reform, the possibility of universal health care seemed to be very unlikely. The new healthcare reform bill that was recently passed under Obama’s administration anticipates covering 30 more million of the uninsured (Riegelman, 2010). However, this bill does not offer universal healthcare. While excellent medical care is available in the United States, the rising cost and the U.S. health care delivery system present many challenges for the consumer and lawmakers. This paper addresses four dimensions that are pivotal to the successes and failures of the system: cost, efficiency, quality. The cost of the U.S. health care system is higher than any country in the world. Its efficiency is also under heavy scrutiny. If it were not an emergency most physicians would require insurance verification. Therefore, patients would be delayed of treatment. Moreover, The healthcare system in the U.S. should be redesigned in terms of prevention rather than treatment when people are already sick. Insurance should not go higher for people that have pre-existing conditions or with more health risks. Prevention and portability of coverage are the main important aspects of the new health care reform. Current health care system in the United States compared to other nations. The cost of health care in the U.S. is the highest in the world today. The...
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...Organizational Design Linda Alicea HCS/514 February 1, 2013 Vinnette Batiste, PhD., MBA Organizational Design of Elmhurst General Hospital Introduction Every hospital, large or small, has an organizational design and structure that will facilitate the efficient and smooth daily operations for the efficient management of various departments (Burton, DeSanctis & Obe, 2004). Within a hospital setting, organizational design is a formal, guided process that integrates employees, patients, people, information, and technology, and serves as a key structural element that also allows Elmhurst to maximize value by matching its corporate design to overall strategy (Glickman, Baggett, Krubert, Peterson, & Schulm, 2007). This paper examines the organizational design of Elmhurst General Hospital as well as its internal and external factors that defines its size, organizational structure and process. Background From a strategic perspective, Elmhurst’s organizational design is more of an untapped variable that needs to be addressed in the context of organizational strategy and change. This is critical as attention to clinical quality is top priority to the hospital, and as such is a priority (Burton et al., 2004; Glickman et al., 2007). This is essential for health-care institutions such as Elmhurst to evolve its organizational and management structures that support the design and implementation of quality-improvement initiatives and at the same time, create mechanisms for accountability...
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...People’s Hospital: An IT-led Upgrading in the New Healthcare Reform PKUPH has seen much trouble in the past. Experiencing financial losses for three consecutive years, reform was needed. With the appointment of Dr. Wang Shan as president, PKUPH has experienced much success by improving efficiency in several areas by outsourcing, launching a new IT-led management system, and improving upon already existing systems. Under Dr. Wang Shan, PKUPH has enjoyed an increase in revenue, nearly doubling from 1.12 billion in 2006 to 2.6 billion in 2012. With an increase in revenue, medical staff income increased as well. However, the implemented changes only benefit medical staff, leaving patients unsatisfied. This is a problem seeing that private hospitals who have received foreign support are becoming more competitive through their proactive marketing and strong brand image. They boast a premium centric hospital environment and world-class doctors. PKUPH could potentially lose patients to these private hospitals. In response to the threat private hospitals impose, PKUPH should focus on establishing a patient-centric environment and increasing medical quality care. By emphasizing customer service through improving billing services and customer relationship management and increasing on-site conveniences and efficiencies in scheduling, PKUPH becomes a more patient-centric, competitive force in the industry. Improvements in the billing service and customer relationship management will better...
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