Healthcare Management
[Author Name(s), First M. Last, Omit Titles and Degrees]
[Institutional Affiliation(s)]
Abstract
Hospitals are facing a critical financial environment regarding several factors, which include public policy changes, expansion in care management, and increased competition related to particular services as well as the uninsured number of people is increasingly growing. The policymakers show their greatest concern, which hospitals might forgo while providing care to poor people in the form of cost reduction. This paper is based on the efficiency of the hospital in relation to uncompensated provisions of care ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"nWuTTnsI","properties":{"formattedCitation":"(Hsieh, Clement, & Bazzoli, 2010)","plainCitation":"(Hsieh, Clement, & Bazzoli, 2010)","noteIndex":0},"citationItems":[{"id":105,"uris":["http://zotero.org/users/local/vDOrLj7p/items/L8M6EF7E"],"uri":["http://zotero.org/users/local/vDOrLj7p/items/L8M6EF7E"],"itemData":{"id":105,"type":"article-journal","title":"Impacts of market and organizational characteristics on hospital efficiency and uncompensated care","container-title":"Health Care Management Review","page":"77","volume":"35","issue":"1","source":"journals.lww.com","abstract":"Background: Hospitals have confronted a difficult financial environment given many factors, including expansion of managed care, changes in public policy, growing market competition for certain services, and growth in the number of uninsured. Policy makers have expressed concern that hospitals may forgo providing care to the indigent as a means to reduce costs and become more efficient when faced with financial pressures.\n Purpose: This article examined the effects of environmental pressures on two dimensions of hospital performance: hospital efficiency and uncompensated care provision.\n Methodology/Approach: Longitudinal data for the Commonwealth of Virginia from 1998 to 2004 were analyzed. Data Envelopment Analysis and bivariate probit were used to examine the factors associated with efficiency and uncompensated care.\n Findings: The results indicated that a positive relationship between hospital efficiency and uncompensated care provision exists. That is, hospitals that are categorized as efficient are likely to provide more uncompensated care. We also found that hospitals tended to provide more uncompensated care when increased demand for these services occurred in a market. Increases in Medicare or Medicaid patient share reduced the provision of uncompensated care. In relation to hospital efficiency, the results indicated that HMO penetration and Medicaid patient share reduced hospital efficiency.\n Practice Implications: This study found that efficient hospitals tend to provide more uncompensated care over time. The findings also suggest that hospitals alter their efficiency and provision of uncompensated care in response to a number of environmental pressures, but it may depend on the type of pressures or uncertainties encountered.","DOI":"10.1097/HMR.0b013e3181c09956","ISSN":"0361-6274","language":"en-US","author":[{"family":"Hsieh","given":"Hui-Min"},{"family":"Clement","given":"Dolores G."},{"family":"Bazzoli","given":"Gloria J."}],"issued":{"date-parts":[["2010",3]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Hsieh, Clement, & Bazzoli, 2010).
Introduction
The hospital's uncompensated care became an increasing issue that is faced by state legislators and the federal government. When the cost of the uncompensated care is compared with total charges and the costs of the total hospital the figures which came out have less proportion of the total value, which is regarded as only 6% of the payments of community hospitals. Although the burden of uncompensated care is not distributed equally among hospitals. On some occasions, this large burden is solely beard by publicly sponsored organizations.
Methodology
In this paper, two different hospital types are selected, and then we observed its institutional differences and similarities while dealing with uncompensated care delivery and also determine ways in which the uncompensated care provision impacts the management policies, financial issues, and management policies ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"6AWJXzj3","properties":{"formattedCitation":"(Hsieh et al., 2010)","plainCitation":"(Hsieh et al., 2010)","noteIndex":0},"citationItems":[{"id":105,"uris":["http://zotero.org/users/local/vDOrLj7p/items/L8M6EF7E"],"uri":["http://zotero.org/users/local/vDOrLj7p/items/L8M6EF7E"],"itemData":{"id":105,"type":"article-journal","title":"Impacts of market and organizational characteristics on hospital efficiency and uncompensated care","container-title":"Health Care Management Review","page":"77","volume":"35","issue":"1","source":"journals.lww.com","abstract":"Background: Hospitals have confronted a difficult financial environment given many factors, including expansion of managed care, changes in public policy, growing market competition for certain services, and growth in the number of uninsured. Policy makers have expressed concern that hospitals may forgo providing care to the indigent as a means to reduce costs and become more efficient when faced with financial pressures.\n Purpose: This article examined the effects of environmental pressures on two dimensions of hospital performance: hospital efficiency and uncompensated care provision.\n Methodology/Approach: Longitudinal data for the Commonwealth of Virginia from 1998 to 2004 were analyzed. Data Envelopment Analysis and bivariate probit were used to examine the factors associated with efficiency and uncompensated care.\n Findings: The results indicated that a positive relationship between hospital efficiency and uncompensated care provision exists. That is, hospitals that are categorized as efficient are likely to provide more uncompensated care. We also found that hospitals tended to provide more uncompensated care when increased demand for these services occurred in a market. Increases in Medicare or Medicaid patient share reduced the provision of uncompensated care. In relation to hospital efficiency, the results indicated that HMO penetration and Medicaid patient share reduced hospital efficiency.\n Practice Implications: This study found that efficient hospitals tend to provide more uncompensated care over time. The findings also suggest that hospitals alter their efficiency and provision of uncompensated care in response to a number of environmental pressures, but it may depend on the type of pressures or uncertainties encountered.","DOI":"10.1097/HMR.0b013e3181c09956","ISSN":"0361-6274","language":"en-US","author":[{"family":"Hsieh","given":"Hui-Min"},{"family":"Clement","given":"Dolores G."},{"family":"Bazzoli","given":"Gloria J."}],"issued":{"date-parts":[["2010",3]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Hsieh et al., 2010). It is required to gather data from various databases. First, acquire financial data of hospitals through their statement of financial income of the selected American hospital, and also gain the annual survey report of AHA ‘American Hospital Association’ which consist the structural data of hospital including bed size, ownership, and the hospital services. Then, take the file of Area Resource and compile it from the Health Professions Bureau, that is important data related to the market structure of the hospital, socioeconomic attributes, and demographic community. This research paper is based on non-federal care hospitals, which are currently in operation in the United States. Take two hospitals, TransUnion healthcare and Definitive Healthcare Hospital. TransUnion provides maximum reimbursement to the unpaid Medicare deductibles. Although, complex rule policies Medicare process hard as well as reporting makes it harder in recovering such payments ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ir3uDmx8","properties":{"formattedCitation":"(\\uc0\\u8220{}Medicare Reimbursement Solutions,\\uc0\\u8221{} n.d.)","plainCitation":"(“Medicare Reimbursement Solutions,” n.d.)","noteIndex":0},"citationItems":[{"id":108,"uris":["http://zotero.org/users/local/vDOrLj7p/items/YXXKBB58"],"uri":["http://zotero.org/users/local/vDOrLj7p/items/YXXKBB58"],"itemData":{"id":108,"type":"webpage","title":"Medicare Reimbursement Solutions","container-title":"TransUnion","abstract":"TransUnion helps identify complex medicare reimbursement opportunities through medicare cost reporting. Learn more about our medicare solutions.","URL":"https://www.transunion.com/product/medicare-cost-reporting","language":"en-US","accessed":{"date-parts":[["2019",11,7]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“Medicare Reimbursement Solutions,” n.d.). This research paper examined the hospitals which enhanced their efficiency as well as reduced their provisions of uncompensated care. It also focused on the environmental variation response due to changes in the market and regulatory factors. It is also observed that the hospitals that provide uncompensated care more have increased demand for indigent care, which is present in their market. Furthermore, the hospitals gave less uncompensated health provisions when, in their market, a safety hospital is already present. The continuous pressure faced by the non-profit hospitals demonstrates that these hospitals provide sufficient advantages to the community, specifically the provision of the services to the population vulnerability. US hospitals required to provide uncompensated care at a high level and also need to be efficient. Although the unique characteristic might facilitate US hospitals to attain balance. The main uncertainty faced while dealing with different hospitals currently is regarded as change types which are resulted in the reforms of health insurance. However, the payment of most of the hospitals which are under IPPS developed based on the standard amount few hospital categories are paid entirely or in parts it is based on the particular rate of the hospital that can be determined through the cost of that base year. Under a recent law, Medicare is based on the small hospitals of rural areas; the program MDH is suitable by FY2022. Through that, MDH acquires the federal rate in a higher amount ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"nD1DwvpA","properties":{"formattedCitation":"(\\uc0\\u8220{}Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2020 Rates; Quality Reporting Requirements for Specific Providers; Medicare and Medicaid Promoting Interoperability Programs Requirements for Eligible Hospitals and Critical Access Hospitals,\\uc0\\u8221{} 2019)","plainCitation":"(“Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2020 Rates; Quality Reporting Requirements for Specific Providers; Medicare and Medicaid Promoting Interoperability Programs Requirements for Eligible Hospitals and Critical Access Hospitals,” 2019)","noteIndex":0},"citationItems":[{"id":110,"uris":["http://zotero.org/users/local/vDOrLj7p/items/52IL7A9Q"],"uri":["http://zotero.org/users/local/vDOrLj7p/items/52IL7A9Q"],"itemData":{"id":110,"type":"webpage","title":"Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2020 Rates; Quality Reporting Requirements for Specific Providers; Medicare and Medicaid Promoting Interoperability Programs Requirements for Eligible Hospitals and Critical Access Hospitals","container-title":"Federal Register","abstract":"We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2020 and to implement certain recent legislation. We also are...","URL":"https://www.federalregister.gov/documents/2019/08/16/2019-16762/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the","issued":{"date-parts":[["2019",8,16]]},"accessed":{"date-parts":[["2019",11,7]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“Medicare Program"; 2019).
Shriners Hospital
Shriner’s hospital is for children, which is continuously expanding the platforms related to the survey of mobile patients, which is performed all over the national organization, which includes clinics and non-profitable hospitals. The major goal of Shriners hospital is to utilize and build the huge pediatric patients database reported by the US PROMs. The services provided by this hospital includes pediatric burn treatment as well as reconstructive and plastic surgery. Their physicians have expertise in cleft lip, burned treatment and also heal the complex skin and wound conditions. It also provides services for reconstructive and plastic surgery of children. This hospital not only treats the patient but also do their best to satisfy the patients’ family each day. This hospital also help parents to come out from stress full situation as children require emotional support and love from their families, especially parents, so, this hospital practice family-centered care approaches. As people came to this hospital from faraway places so, this hospital provides them access to the ‘specialty care’ through utilizing the interactive video session between a patient and its family with the Shriners hospital medical team. It helps patient's family to communicate life in the interactive video conference and it saves both time and cost. It is analyzed that the major revenue source for patients services Medicaid $79,997 and commercial payers $123,869. Shriner’s management regularly reviews the data related to patient services sources for the evaluation of allowance adequacy. The investment in mineral interest and real estate are calculated based on several information sources related to the type of assets. While the identification of fair value can be made through the utilization of quoted prices through utilizing the active market liabilities. Shriner's total net assets and liabilities are $972,029, while the total assets, including buildings, equipment, and land, are $10,465,342.
References
ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Hsieh, H.-M., Clement, D. G., & Bazzoli, G. J. (2010). Impacts of the market and organizational characteristics on hospital efficiency and uncompensated care. Health Care Management Review, 35(1), 77. https://doi.org/10.1097/HMR.0b013e3181c09956
Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2020 Rates; Quality Reporting Requirements for Specific Providers; Medicare and Medicaid Promoting Interoperability Programs Requirements for Eligible Hospitals and Critical Access Hospitals. (2019, August 16). Retrieved November 7, 2019, from the Federal Register website: https://www.federalregister.gov/documents/2019/08/16/2019-16762/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the
Medicare Reimbursement Solutions. (n.d.). Retrieved November 7, 2019, from TransUnion website: https://www.transunion.com/product/medicare-cost-reporting
