Case Study - Analyzing Managerial Decisions: Interwest Healthcare Corp. 1. What are the potential sources of the problem? Interwest Healthcare Corp has 10 hospitals. Each hospital is responsible for maintaining accurate records in the firm's management information system.
As it relates to HIPAA, incentives for individuals are being able to access his or her information in a timely manner by participating in the EHR incentive program. The programs operate together by making certain information available quicker to patients. On the other hand, DDE does not offer incentives because it is an option but DDE does work hand in hand with EHR because DDE is data transferred directly to providers.
1. What are the strengths of the current Medicaid care management system in North Carolina? The state of North Carolina, arguable has had positive reviews concerning Medicaid. With one of the biggest issues concerning the United States being the costs associated with care, and the consistent increase in these costs, North Carolina has been one of the top states to reduce costs.
Direct and limited reimbursement plans are different. Direct expense reimbursement plans designate reimbursement of all expenses that are reasonable within the sales effort of salespeople (Johnston & Marshall, 2009). Limited expense reimbursement plans allow for a pre-set limit of expenses (Johnston & Marshall, 2009). The pre-set limit of expenses can be reimbursed for specific expense occasions or provided as a one time expense budget payment. The type of reimbursement plan that would work best for the MedTech Pharmaceuticals company would depend upon the goals of the company.
Do you believe that contribution margins can help you manage in your current position? Why or why not? Do you think you would use break-even analysis? Why or why not? What do you think are the overall benefits of utilizing these analysis tools within a health care organization?
The term “revenue cycle” is most often used in the healthcare industry. Revenue cycle means all administrative tasks that contribute to tracking and managing claims as well as, the collection of patient service revenue, (Key Strategies for Modernizing the Revenue Cycle, 2015). The healthcare revenue cycle process means determining patient eligibility, collecting co-pays, managing claims, collecting payments, and following up on denied claims (Consolver & Phillips, 2014). In general this means the entire patient engagement of their account from beginning to end. Revenue cycle refers to anything that has to do with billing.
Discuss the ethical implications of “medical necessity” in patient care. Ethical Implications of Medical Necessity When it comes to medical necessity can often refers to the determination that is made for the insurance purposes. For example, If the patient has a condition that is chronic or terminal, the treatment could be considered medically necessary whether then the patient can afford the treatment or not. Networked doctors may face ethical dilemmas when recommending treatment or specialist referrals. When it comes to medical necessities it can be controversial, it can be the use of marijuana when there can be others that are more a moral ethical in which it can be in manage care and network providers.
How do you see this position tying into your career path? (Respond in 100-200 words.) I believe the transition will be a natural segue, as I continue my career this position will enable expanded knowledge of person assistant duties. The primary functions of the position I desire is full of on the job training. The idea of working for such an accomplished and successful employer is bewildering.
Medicare Solvency The Medicare Program is one of the largest social programs funded by the government to paid health care services for the elderly, disabled and individuals qualifying to receive Social Security benefits. It is financed by payroll taxes, premiums, and surtaxes from beneficiaries and it is currently divided into four parts A, B, C, and D. Part A is the Hospital Insurance (HI); Part B is the Supplementary Medical Insurance (SMI); Part C is the Medicare Advantage (MA) which is a combination of parts A and B, and Part D is the Prescription Drug Coverage (Shi and Singh, 2015). There are three main factors that are affecting the Medicare solvency: the cost of health care services is growing faster than the general economy’s inflation
Based on this case the cost driver is to properly distribute the direct cost among the different divisions. Dr. Julian would like to control her departments costs by having them distributed fairly among the divisions without affecting the hospital’s reimbursement/revenue. Carroll University Hospital is currently using the standard costing unit, which is based on the cost of bed/day for inpatients. Currently the present cost accounting system that is being used at CUH takes the total direct cost of the departments, then allocates the indirect costs and distributes it among the departments evenly regardless of the actual resources being used in those departments, and without considering that there may be some patients in these divisions that may require more resources than others, this method does not seem to recognize the different activities,
The pricing strategy or pricing policy is one of the most important managers make for a product as it affects the profitable outcome and competitiveness that a product may make. (Toni, 2017). A business can use a variety of pricing strategies when selling a product or service. The price can be set to maximize profitability for each unit sold or from the market overall. It can also be used to defend an existing market from new entrants, to increase market share within a market or to enter a new market by dropping the price or offering more benefits with the device such as packages.
V.Postolache (2014), argues that Management Accounting take a leadership role in their teams and they provide valuable information that guides the organization towards achieving its strategic goal. The monthly budget is discussed in the Management meeting and the following key ratios and statistics are analyzed and comparison made. • Net Interest Margin • Credit Loss Ratio • Cost to income ratio • Return on equity • Return on assets • Loans to deposits ratio • Cost of Funding and other ratios not mentioned in this paper. Cost associated with Management accounting which BancABC uses to gauge company performance that are relevant are Breakeven point, operational budgeting, activity based costing etc.
4.4 Pricing Strategy For a number of reasons, price is one of the most important aspects of an effective marketing strategy (Gerstein & Friedman, 2015). First, price is the only marketing variable that generates revenue. Second, buyers see price as an attribute of value (Tanner & Raymond, n.d.). Consequently, an organization must carefully assess its internal and external environment to choose the most effective pricing objective, which—in turn—will drive a product’s initial pricing strategy.
What insight is provided by the new profitability analysis? What should Alice, Inc. do to enhance its profitability? What options may be available? Analyze the profitability of the two products
6.1.2 Price Price is the value or amount that customer pays to buy a product. For instance, for our Star Lab ice cream shop, we need to consider the cost of production of our ice cream, price of our main competitor and our potential customers demographics in order to succeed this competitive market. (C. Breidert, 2007, p.9) 6.1.2.1 Pricing Strategy Pricing strategy that can be used by our company such as penetration pricing, cost-plus pricing, value based pricing and more. But we think that market penetration pricing is the best pricing strategy to be used by our business.
