Describe the type of facility by which you are employed.
Because you have been in the program for a while now, you have had many opportunities to get to know others in the group fairly well. For this introduction, we’re going to shift gears a bit. During this course you will be relating many of your discussions and assignments to the project proposal you created in NR505. Please introduce yourself to the class and instructor and include the following information.
Describe the type of facility by which you are employed.
Your current position and for how long
Your prior experience in financial management
Share the PICO(T) you developed in NR505 and/or the one you will be using in your final project.
What led you to choose this issue/topic?
DQ2 Touchpoint Reflection: Healthcare Systems’ Financial Environments
Guidelines for Touchpoint Reflections
Touchpoint Reflections: This is a new type posting that occurs in the same type portal as the discussion thread. However, these are treated as “mini”-weekly assignments”. You will be able to see and read the posts of peers but are not required to respond to them. However, if someone responds to your TPR, replying their post is always the collegial thing to do. Your grade is not affected either way.
There are specific formatting and content guidelines. Remember to use the headings as defined to address each section, Experience, Reflection, Implications, in your responses. A downloadable version of the guidelines, which includes further information, is available for access below. You are encouraged to download these guidelines and rubric to avoid the need for referring back to this page for the link.
EXPERIENCE
Understanding how your organization is reimbursed for services depends on several components. Assess your organization and identify its care delivery system and payer mix make up. Include percentages represented by each payer group. Identify the key people in your organization from whom you obtained your information. Perhaps it is your unit director, operational directors, financial officers, CNOs. Your direct supervisor might be able to point you in the right direction, Since the information required is often available to the public through public reports you might also access the information through online searches of internal systems or external internet searches.
Your Name’s Healthcare Organization
Healthcare Delivery System (Type)
Payer Mix
Percentage
Medicare
Medicaid
Managed Care
HMO
PPO
IPA
Self-pay
Uninsured
REFLECTION
Based on this data, discuss the assumptions that could be made about the population demographics for your institution. What influence do these variables have on the types of services offered at your facility?
IMPLICATIONS FOR THE FUTURE
What might your analysis tell you about the long-term health of your community?
What future needs might be identified?
NR533 Financial Management in Healthcare Organizations
Week 2 Discussion
DQ1 Volume-Based Versus Value-Based Reimbursement
Venn Diagram for Discussion Assignment (Week 2)
Models of payment to healthcare organizations have begun to shift from paying for volume (fee for service) to paying for value (quality). Using a Venn Diagram, compare volume-based versus value-based reimbursement. Be sure the overlapping area contains the commonalities between the two systems.Use the editable template for the Venn Diagram, which is available for download above. This template (with your findings) will need to be posted as an attachment in your discussion post along with your written prompt.
Consider Jim, who is 69 years old and comes to your Emergency Department (ED) with severe abdominal pain. His evaluation, besides a physical exam, includes an abdominal ultrasound, a CT scan with and without contrast, multiple lab studies, all lead to his having an emergency appendectomy. Other than having Type II diabetes well controlled on diet and exercise, he is in otherwise good health. Jim is treated as an outpatient and is discharged home the next morning. Two weeks later he returns to the ED with fever, continued abdominal pain, and a surgical site infection. He is admitted and is treated for 5 days before being sent home.
Using your findings from your comparison of volume- versus value-based reimbursements, analyze the scenario. Determine how the hospital could charge and be reimbursed using the two methods. In this case, which would be better for the hospital? How do each of these payment models contribute to or detract from the goal of the Triple Aim? Considering payer mix, delivery systems, population demographic, and value-based purchasing of the institution. How do all of these elements influence the financing of the type and quality of care provided at your facility? What are the implications on access and availability of types of care provided by your institution?
DQ2 Touchpoint Reflection: Reimbursement Issues
Guidelines for Touchpoint Reflections
A downloadable version of the guidelines, which includes further information, is available for access in the week 1 discussion thread.
Reflection Information
EXPERIENCE
Using the data collected in Week 1 about your institution’s, provide an overview of the payer mix , delivery system type, and the population demographics. Describe the type of reimbursement system relied upon most heavily by your institution; value- or volume-based.
REFLECTION
Describe how these factors coalesce to influence the financing of the type and quality of care provided at your institution. What are the implications on access and availability of types of care provided at your institution?
IMPLICATIONS FOR FUTURE
How is your proposed project affected by the information you’ve gathered about your facility?
What adjustments might you have to make in your proposal because of the information gathered?
NR533 Financial Management in Healthcare Organizations
Week 3 Discussion
DQ1 Process of Budget Preparation
After exploration of the types of budgets and the processes for their development at your institution. How and from whom is input into the budgets acquired and used? Where does control of the budget lie? What influence do unit and midlevel managers have on the various kinds of budgets?
DQ2 Touchpoint Reflection: Financial and Budgeting Principles
Guidelines for Touchpoint Reflections
A downloadable version of the guidelines, which includes further information, is available for access in the week 1 discussion thread.
Reflection Information
EXPERIENCE
This week’s readings contained a great deal of information on financial and budgeting principles. Some of you may have had some familiarity with the concepts and maybe even experience in working with them. However, there is always something new to learn. Describe your prior experiences with financial and budgeting principles, whether personally or professionally. Include your current involvement in budgeting at your institution.
REFLECTION
What pre-conceived notions related to healthcare financial and budgeting principles did you hold before this week that you understand better now or for which you have a different perspective? Reflect on at least two specific concepts. How have these new revelations influenced your thinking related to access, availability, and quality of healthcare?
IMPLICATIONS FOR THE FUTURE
How has your enhanced knowing affected the way you view your proposed project?
What areas of additional financial or budgeting data gathering have you identified as a need for your plan?
NR533 Financial Management in Healthcare Organizations
Week 4 Discussion
Staffing Ratios
Staffing is one of the largest expenditures for healthcare organizations. It stands to reason that for some organizations a mandatory staffing ratio could negatively impact their financial bottom line. Sometimes ratios can be different within an organization based on acuity of patients or type of unit. Explore your own organization staffing ratio policy. What is/are the ratio(s) and how they are determined? What variables affect the ratios? Have they been mandated by state legislation or organizational policy? How is your operational budget (unit or department) affected by the staffing ratio assigned to it?
NR533 Financial Management in Healthcare Organizations
Week 5 Discussion
Cost-Benefit Analysis
Consider and restate your PICO(T) and the proposal for your final project. When you think of it as a type of new program development, what specific information will you need to obtain to create the cost-benefit analysis as part of your business plan for the project?
NR533 Financial Management in Healthcare Organizations
Week 6 Discussion
Business Plan Development: SWOT analysis
For any new project or revision of a current process, key questions that will need to be answered are whether it’s needed, does the institution have the capacity to support it, what is already in place that will facilitate implementation, and what are the downsides or barriers to development. In short, the SWOT analysis is a necessary component of planning a project and preparing the business plan. Critically examine your PICO(T) and project proposal through the lens of a SWOT analysis of your organization. Determine and describe what information you know and what you need to find out to complete a SWOT analysis that will provide rationale and validity for your project.
NR533 Financial Management in Healthcare Organizations
Week 7 Discussion
Business Plan
In addition to being fiscally sound, cost neutral, or revenue producing, a new program/major change must fit with the organization’s philosophy, vision, mission, and strategic plan. Describe with specific examples how your project fits in with your institution’s philosophy, vision, mission, and strategic plan.
Drawing upon your knowledge of various change theories and in particular the McKinsey Influence Model, how will you go about engaging stakeholders to adopt your proposal for change?
NR533 Financial Management in Healthcare Organizations
Week 8 Discussion
Touchpoint Reflection: Finance, Budgets, and Business Plans-“Oh my!”
Guidelines for Touchpoint Reflections
A downloadable version of the guidelines, which includes further information, is available for access in the Week 1 discussion thread.
Reflection Information
This is the final week of discussion and there are two important areas of reflection included in this discussion. Please label each area with a heading to facilitate classmate and instructor response.
EXPERIENCE
Post your executive summary.
Compare your pre-and post-self-assessments.
REFLECTION
Discuss the strengths and weaknesses to the business plan for your final proposal.
Identify areas of strength and weakness related to financial and budgeting principles discovered through your pre- and post- self-assessments comparison.
IMPLICATIONS FOR THE FUTURE
What adjustments are needed for you to create the most compelling plan?
What concepts from the course do you need to study further?
What is your plan for enhancing your knowledge of finance and budgets in the healthcare organization?
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