answer my quastions

Health Medical

Question Description

Hello

I will send you around 4-6 quastion so please read the chapters from 11-15 also i will send u the chapters from the textbook latter. keep in mind that dome snswers will be from spesfice pages.

Unformatted Attachment Preview

Health Administration Press Chapter 15 Holding the Gains Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Holding the Gains • Types of projects to select • Backlogs • Revenue less than expense • Poor outcomes • Engage support departments • Tools • Human resources planning • Managerial accounting • Feedback and control Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Human Resources Planning Project identified Decrease staffing? No Plan for maintaining staff Yes Vacant position? Yes Eliminate vacant position No FTEs needed in other department? Retrain and pool or redeploy Yes No Copyright © 2017 Foundation of the American College of Healthcare Executives. Lay off Health Administration Press Holding the Gains: Managerial Accounting • Understand the source of revenue • • • • Per member per month (PMPM) Diagnosis-related group (DRG) (case-mix adjusted) Unit of service—relative value unit (RVU) Retail • Determine costs • Fixed • Variable • Overhead—allocation methodology • Conduct cost-volume-profit analysis (CVP) Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press CVP: Examples Backlogged Financial Loss Base PI Project Base PI Project 1,000 1,500 1,000 1,050 Revenue/test 150 150 150 150 Total revenue 150,000 225,000 150,000 157,500 38 38 38 38 Fixed costs 85,000 85,000 120,000 80,000 Overhead 20,000 20,000 20,000 20,000 143,000 162,000 178,000 139,900 7,000 63,000 (28,000) 17,600 Test volume Costs Variable cost/unit Total cost Profit Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Holding the Gains: Control Birthing Center Patient Satisfaction 90 80 Facilities Clinical Quality 70 High Touch 60 Ju ne M ay Ap ril Au gu Se st pt em be r Oc to b No er ve m b De er ce m be r Ja nu ar y Fe br ua ry M ar ch 50 Ju ly Percentage Satisfied or Be tter 100 Run chart for birthing center patient satisfaction Month Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Develop and use a balanced scorecard (4) Start Issue formulation (6) Data collection and analysis (7) Use formal project management approach (5) Yes Yes Yes Is the issue strategic? Focus on improving quality or reducing variation? No Focus on reducing waste or improving flow? Focus on what if issues? No Data collection and analysis is used in conjunction with a number of operations improvement tools and their use is indicated by this box No No Focus on supply chain Yes Yes Large project? Use six sigma tools (8) Data No Focus on scheduling? Yes Scheduling (12) Data Yes Use simulation (10) No Use lean tools (9) Data Data Apply basic process improvement tools (11) Yes No Data Hold the gains (14) End Copyright © 2017 Foundation of the American College of Healthcare Executives. Use SCM (13) Health Administration Press Levels of Operational Excellence • Level 1 • No organized operations monitoring or improvement efforts at this level. • Quality efforts are aimed at compliance and the submission of data to regulatory agencies. • Level 2 • Organization has begun to use operations data for decision making. • There are pockets of process improvement activities in which process mapping and plan-do-check-act or rapid prototyping are used. • Evidence-based medicine (EBM) guidelines are used in some clinical activities. Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Levels of Operational Excellence • Level 3 • • • Senior management has identified operations improvement efforts as a priority. Organization conducts operations improvement experiments, uses a disciplined project management methodology, and maintains a comprehensive balanced scorecard. Some pay-for-performance (P4P) bonuses are received, and the organization obtains above-average scores on publicly reported quality measures. • Level 4 • • • Organization engages in multiple process improvement efforts, using a combination of project management, Six Sigma, Lean, and simulation tools. A significant number of employees have been trained in the advanced use of these tools, and these individuals lead process improvement projects. EBM guidelines are used comprehensively, and all P4P bonuses are achieved. Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Levels of Operational Excellence • Level 5 • • • • • Operational excellence is the primary strategic objective of the organization. Operations improvement efforts are under way in all departments, led by departmental staff who have been trained in advanced tools. The organization uses real-time simulation to control patient flow and operations. The organization develops and publishes new EBM guidelines and best practices for administrative operations. The organization scores in the top 5 percent of any national ranking of quality and operational excellence. Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press The Future Ambulatory care model— EBM based Demand prediction system: Volume—clinical conditions Predicted resource needs: • Facilities • Staff • Supplies Emergency and inpatient care model—EBM based Staff scheduling system Supply chain system Real-time control Real-time data Clinical operations Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press End of Chapter 15 Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Chapter 14 Improving Financial Performance with Operations Management Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press The MEDPAC study (2016) • Annual report to Congress on hospital payment rates • In 2014, hospitals’ aggregate Medicare margin was 5.8% • A set of relatively efficient hospitals broke even on Medicare while scoring high quality metrics • Hospitals’ marginal profits under Medicare are 10% • Payment rates projected to decline due to $3 billion decline in uncompensated care payments • -9% aggregate Medicare margin projected for 2016 • Not said but implied—“If they can do it , why can’t you?” Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Factors Increasing Costs • Increasing incidence of chronic disease and an aging population • New diagnostic and treatment technologies • Increasing complexity of billing and payment systems • A provider payment system (fee-for-service) that encourages the use of healthcare services Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Measures of Financial Performance • Cash on hand • • • • • Percent of debt financed Age of plant Revenue (growth or decline) Profit margin Costs (per unit of service) Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Short-Term and Ineffective Approaches to Cost Reduction • Across-the-board expense reductions • Elimination of overtime without changing any processes • Using less expensive supplies without changes in the supply chain • Tolerating queuing and long waits for service • Outsourcing key activities without quality monitoring systems in place Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Systems Approach to Cost Reduction • Identify overhead expenses and expenses directly related to revenue • Revenue categories • • • • • • Fee-for-service Bundled Shared savings Full capitation Quality bonuses or penalties Global budgets Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Cost-Reduction Approach • Collect detailed data • Identify variances in resources used and outcomes achieved • Improvement methods • Process improvement including Lean and Six Sigma • Supply chain management • Schedule optimization Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Fee for Service • Lowest, “atomic” level of costs • Use activity-based costing (ABC) • Identify the relevant activities • Determine the total cost of each activity, including direct and indirect costs • Determine the cost drivers for the activity • Collect activity data for each service • Calculate the total cost of the service by aggregating activity costs Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press ABC: Step 1 Activity Annual Cost ($) Cost Driver Check-in 50,000 Number of visits 5,000 5,000 10,000 5.00 75,000 Number of minutes per visit 5 10 75,000 1.00 Diagnosis 250,000 Number of minutes per visit 10 15 125,000 2.00 Treatment 450,000 Number of minutes per visit 10 20 150,000 3.00 2,500 Drugs prescribed per visits 0.5 2.0 12,500 0.20 50,000 Number of visits 5,000 5,000 10,000 5.00 Billing 150,000 Number of bills per visit 1.0 2.0 15,000 10.00 Total costs 1,027,500 Assessment Prescription Check-out Service A Activity Data Service B Activity Data Copyright © 2017 Foundation of the American College of Healthcare Executives. Total Activity Data Allocation Rate ($) Health Administration Press ABC: Step 2 Activity Cost Driver Check-in Number of visits 5.00 1 5.00 1 5.00 Assessment Number of minutes per visit 1.00 5 5.00 10 10.00 Diagnosis Number of minutes per visit 2.00 10 20.00 15 30.00 Treatment Number of minutes per visit 3.00 10 30.00 20 60.00 Prescription Drugs prescribed per visits 0.20 0.5 0.10 2.0 0.40 Check-out Number of visits 5.00 1 5.00 1 5.00 Billing Number of bills per visit 10.00 1.0 10.00 2.0 20.00 Total cost per service Rate ($) Service A Consumption Service A Service A Cost ($) Consumption 75.10 Copyright © 2017 Foundation of the American College of Healthcare Executives. Service B Cost ($) 130.40 Health Administration Press Cost Reduction Tools for Each Activity Activity Improvement Tools Opportunity Check- in • Process improvement (Lean, Strong Six Sigma, simulation, etc.) • Automation Assessment Process improvement Low Diagnosis Evidence-based medicine Medium Treatment Evidence-based medicine Medium Prescription Supply chain management Strong Check-out • Process improvement Strong • Automation Billing • Data mining and analysis Strong • Process improvement Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Bundled Payment Types • Per diem—All payments for a day in a hospital are paid at one rate. • Medicare prospective payment—All payments for a stay in the hospital are paid at one rate that is adjusted for the complexity of the admission by the diagnosis-related group system. • Medicare bundled payments—All payments for an “episode of care” are paid at one rate, adjusted for complexity. Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Cost Reduction for Bundled Payments • Identify bundles with: • High volume • High cost compared to benchmarks from other organizations • High use in bundled payments where costs are highly variable • Reduce costs of FFS components • Use evidence-based medicine (EBM) to identify and use the most effective clinical protocols Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Shared Savings: ACO Cost Management • Data tools to track patients over time • Six Sigma analysis and improvement • • • • • • Run and control charts Pareto diagrams Cause-and-effect diagrams Scatter plots Regression analysis Benchmarking • Chronic disease management using EBM Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Full Capitation Cost Control • Disciplined attention to improving systems of care • Additional tools • Implement healthcare home • Implement shared decision making for surgery based on EBM findings • Develop new systems to prevent readmissions of Medicare patients through EBM and process improvement Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Quality Bonuses or Penalties Develop teams—use process improvement (PI) tools and EBM • • • • • Readmissions reductions Length-of-stay management Hospital-acquired infections and conditions reduction Joint Commission core measures Publicly reported quality measures (Healthcare.gov) Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Global Payment: Annual Budget Cost Management Tools • Balanced scorecard strategy maps and reporting • Data mining, benchmarking, and statistical tools to identify opportunities for cost reductions • Process improvement with Lean and Six Sigma with a special emphasis on services that are developing queues • Scheduling and capacity management • Supply chain management Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Controlling Overhead Expenses • Implement PI on all routine overhead processes (e.g., hiring new employees) • Consolidate activities (e.g., memberships) • Reduce staffing layers • Reduce meetings—use automation tools • Focus on capital cost reduction and effective space use Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Prioritize Overhead Activities Function B Function C Importance Function A Function D Cost Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Optimize Revenue • Provide real-time information to claims processors through data warehouses • Use exception-based workflow, in which processes are mapped and automated and only exceptions are handled by staff • Provide real-time feedback to clinicians about the impact on reimbursement of care choices (e.g., medication choice) • Automate most tasks in the revenue cycle • Enhance online functionality for customers Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Benefits Health System • In 2008, Medicare covered just 75% of costs for this patient segment • Goal: Break even on Medicare payments • Improvements • • • • • Benchmarking productivity Reducing staff overtime and readjusting staffing mix Managing through attrition Increasing automation capabilities Renegotiated contracts and better supply chain efficiency • Results • By 2012, Medicare business produced a slight operating margin Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press End of Chapter 14 Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Chapter 13 Supply Chain Management Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Supply Chain Management (SCM) • What is supply chain management (SCM)? • • • • • • • Why is SCM important for healthcare organizations? Tracking and managing inventory Forecasting Inventory models Inventory systems Procurement and vendor relationship management Strategic SCM Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Supply Chain Management (cont’d.) • The management of all activities and processes related to both upstream vendors and downstream customers in the value chain • Tracking and managing demand, inventory, and delivery • Procurement and vendor relationship management • Technology enabled Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press SCM in Healthcare • Potential savings of 2–8% of overall operating costs with effective supply chain management of tangible goods • Procurement costs can be reduced >10% • Quantity of items purchased can be reduced >20% • With $500M+ hospital budgets, savings potential is enormous Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Inventory • Inventory is the stock of items held by the organization either for sale or to support the delivery of a service • Inventory management answers three questions: • How much to hold • How much to order • When to order Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Functions of Inventory • To meet anticipated demand • To level process flow • To protect against stockouts • To take advantage of order cycles • To help hedge against price increases or to take advantage of quantity discounts • To decouple process steps Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Effective Inventory Management • Classification system • Inventory tracking system • Reliable forecast of demand • Knowledge of lead times • Reasonable estimates of: • Holding or carrying costs • Ordering or setup costs • Shortage or stockout costs Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press ABC Classification System • Classifying inventory according to some measure of importance and allocating control efforts accordingly • Pareto Principle - A very important - B moderately important High (80%) Annual $ volume of items A B C Low (5%) Few (20%) - C least important Many (50%) Number of Items Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Inventory Tracking • Track additions and removals • Bar coding • Point of use or point of sale (POS) • RFID • Physical count of items • Periodic intervals • Cycle count • Find and correct errors Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Forecasting • Exercises • Averaging methods • Trend, seasonal, and cyclical models • Model development and evaluation • VVH example Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Forecasting: Exercise 1 • Identify the pattern and construct a formula that will “predict” successive numbers in the series. • What is the next number in the series? (a) 3.7, 3.7, 3.7, 3.7, 3.7, 3.7, 3.7, 3.7 (b) 2.5, 4.5, 6.5, 8.5, 10.5, 12.5, 14.5, 16.5 (c) 5.0, 7.5, 6.0, 4.5, 7.0, 9.5, 8.0, 6.5 • What is the formula for the next number in the series? Copyright © 2017 Foundation of the American College of Healthcare Executives. Health Administration Press Exercise 1: Graphs Series b 18 16 14 12 10 Series1 8 6 Series a Series c 4 4.4 2 10.0 4.2 0 9.0 1 2 3 4 5 6 7 8 4.0 8.0 7.0 3.8 6.0 Series1 3.6 Series1 5.0 3.4 4.0 3.2 3.0 3.0 2.0 1.0 2.8 1 2 3 4 5 6 7 8 0.0 1 Copyright © 2017 Foundation of the American Col ...
Student has agreed that all tutoring, explanations, and answers provided by the tutor will be used to help in the learning process and in accordance with Studypool's honor code & terms of service.
Tags:

This question has not been answered.

Create a free account to get help with this and any other question!

Similar Questions
Related Tags