Compare And Contrast The Clinical And Budgetary Frameworks Of Healthcare Drivers
California Sutter Health in Northern California, is a not-for-profit health system that includes doctors, hospitals and other health care services. In 2006, this healthcare provider discovered the need to improve its patient collection process. Being one of Northern California 's largest healthcare providers California Sutter Health took an innovated approach to come up with a solution to improve their financial collection from patients. An article tells us “Sutter Health, is committed to giving its patient financial services (PFS) staff on both the front and back ends the tools they need to improve patient collections and thus the system 's bottom line” (Souza & McCarty, 2007). By addressing the appropriate problems, Sutter Health
They should be hold accountable for any breach in protocols. • Present format for electronic documentation does not allow for comprehensive clinical documentation during follow-up visit. Efforts should be made to upgrade the electronic medical record system to the standard of that expected for a medical center and research institute. This is to allow for proper documentation according to the industrial standard, and easy retrieval of patient’s information for clinical research. There is a need to employ a clinical documentation improvement specialist (CDIS) in this
Increasing costs all around the globe due to economic downfalls is making this issue even more challenging. It is vital that we have some focus on revenue, but we can’t lose focus on the costs of running a business. In health care this can be very challenging because of all the changes involved with the government, in laws regarding health care reform. “Understanding the total costs of services will allow the redeployment of resources which provide a higher payback, or will facilitate the elimination of those resources altogether.” (Hughes, 2011).
What information does the personal health record contain? • Patients name • Birthdate • Blood type • Emergency contacts • Any known allergies • Family history • Date of last physical • Dates of any major illnesses and surgeries • Test results and
In 2010, the aggregate shortfall of government funding for Medicare and Medicaid beneficiaries was estimated at $28 billion dollars. Currently, Medicare and Medicaid in combined do not cover the complete cost of care for program recipients but their beneficiaries account for about half the care provided by hospitals . In the chart it shows the uncompensated care and payment shortfalls from Medicare and Medicaid in billions of dollars, 2010 Similarly, between 2000 and 2010, the cost of uncompensated care grew by 82 percent, from $21.6 to $39.3 billion. In the below chart it shows the cost-based uncompensated care in billions of dollars, 1990 – 2010 .EMTALA’s
A Medicare Severity-Diagnosis Related Group (MS-DRG) is a system of sorting a Medicare patient’s hospital stay into many groups in order to expedite payment of services for Medicare patients (CMS, "Acute Inpatient PPS") . The MS-DRG is the most-widely used system today as a result of the rising number of Medicare patients. Payments are calculated using wage variants, geographic locations, and the percentage of Medicare patients that a hospital treats (CMS, "Acute Inpatient PPS"). In short, the Medicare Severity-Diagnosis Related Group (MS-DRG) system enables the Centers for Medicare and Medicaid Services (CMS) to provide improved reimbursements to hospitals serving more severely ill patients. Hospitals treating less severely ill patients will receive less reimbursement.
The authors of this journal discuss the healthcare systems cutbacks and its impact on the population. Every few years the Ontario government and the Ontario Medical Association (OMA) negotiate their contract called The Physician Services Agreement (PSA) The contract details how much physicians can bill for their services, as well as where health care funding should be invested in or where a cut back could be. In March of 2014, the contract had expired, which has led to negotiations for over the year. Over that year negotiations for the new PSA contract had many conflicts mostly due to the government’s goal try to end the province's deficit by 2017-2018.
Overall, incomplete documentation and delinquent medical records cause inaccurate reimbursement and results in inaccurate gross revenue to the hospital. It can have a negative impact on the hospital budgeting and financial planning process for the hospital. It is for this purpose that every healthcare institution should be purposeful on reviewing the accuracy and completeness in clinical documentation, no matter the cost. Even though, for most physicians, most of their time is focused on the actual care of the patient and there is little to no time to devote to extensive documentation, it is imperative to understand patient care includes both the one-to-one attention and the documentation of said treatment.
Assignment – There are five common purposes for medical records. List each of these purposes and provide an example of each in healthcare. Having good medical records is very important, for the proper care of patients. “Medical records can be used to manage healthcare, track healthcare, provide clinical data, meet regulatory requirements, and document healthcare” (Allen, 2013, P. 57). Without the proper documentation there is no proof that it was ever done.
Seventy years onward, those initial aims are still the guiding principles, however they are under increasing threat as a result of the systemic financial problems. These financial struggles can be tracked right back to the inception of the NHS, where, in 1952, charges were introduced for prescriptions and dental treatment in response to unforeseen accumulating expenses3. The NHS expenditure has escalated from £437m in 1948 (currently £15bn, accounting for inflation) to £140.6bn in 2015/16, which represents approximately a 10-fold increase4. The problem lies in the fact that the exponentially increasing expenditure is not being matched by the budget being generated through taxation. In 2013/14, NHS England predicated the financial gap would reach
Albeit both have its benefits and setbacks, the both also have qualities a new healthcare system needs. Both of these plans satisfied the needs of the public, such as insurance transfer and low prices. In order to keep those features with our competitive, ever-growing economy and inflation, it might be best to keep spending rates at 20% for some years. With this budget, scientists could still develop new technology. However, doctor’s salaries would have to be lowered.
For this presentation, our topic was researched on U.S. healthcare systems. Since this was a very broad topic, we decided to break it down into three major components of the system in general. Therefore, we wanted to aim to explain the three major components of: before you go to seek medical attention, the management of these facilities once you get there, and the billing and treatment you receive once you have been helped. Within this paper, we will explain each step that the U.S. government has taken in regards of these components.
First off, I am humbled to be considered for membership of the National Honor Society. In my opinion on the foundation of the four pillars of NHS the FPC NHS chapter will benefit from my membership because I will bring intellect, drive, leadership, character, dedication to serve my community, honesty, respect, pride, discipline, compassion and among many other qualities a sense of humor. As an active member of my school and community I work hard to serve not just myself but those around me. I am an active volunteer throughout Flagler County as previously stated. I am a teenage volunteer at the Florida Hospital Flagler.
The model of the Five Competitive Forces, developed by Michael E. Porter, is based on corporate strategy, industry structure and the way they change. Porter has identified five competitive forces that shape every industry and every market and they determine the intensity of competition and hence the profitability and attractiveness of an industry. We further look into how the strategy and industry structure is placed in the field of healthcare and hospitals and analyze the attractiveness of the overall industry. 2.2 Rivalry among competitors Industry Rivalry is one of the 5 forces used to determine the intensity of competition in the industry. Competition in health care is the potential to provide with a mechanism to reduce cost and hence accessible
o Food intake: Document the patient’s food and liquid intake. o Observation of the sick: Observe the patient, and document the observation. o Bed and bedding: Keep the bed comfortable, dry and wrinkle free.
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