Middlefield Hospital- Strategic Recommendation
Middlefield Hospital
Strategic Report
I. Executive Summary
Content for Executive Summary included here
II. Issue Identified
Content for Issue included here
III. Strategy for Improvement
Content for strategy included here
IV. Recommendations
Content for recommendations included here
V. References
Page 1
Scenario Summary
You have been the Director of Operations for Middlefield Hospital for 2 and a half years and finally resolved the workforce challenges that plagued the hospital, and in particular the mental health unit. In a recent meeting, the chief financial officer (CFO) indicated that the financial performance of the hospital’s mental health unit has been deteriorating over the last six (6) months, and the quality of care delivery has been impacted. The hospital is not meeting its budget and he is concerned about the future. The new facility across town has continued to cut into Middlefield’s market share by admitting more patients. The number of admissions to Middlefield Hospital is declining each month, and more uninsured patients are seeking services at your facility. You convene the Middlefield Hospital management team and discover a few interesting facts, which are identified below.
1. The payer mix of Middlefield Hospital is comprised of more and more Medicare, Medicaid, and uninsured patients, and fewer patients have commercial insurance. This is reducing overall reimbursement and net income for the hospital.
2. The nearby hospital that competes with Middlefield has opened a wellness center that offers a comprehensive array of preventative and wellness services to the community. This facility is attracting young families to seek services at this location.
3. Most of Middlefield’s managed care contracts are more than 2 years old. There are little reliable utilization and reimbursement data available. No one
at Middlefield Hospital is assigned to manage these contracts or maintain ongoing relationships with managed care companies.
4. The Joint Commission survey is scheduled for next year, and there are significant problems with the hospital’s quality/performance improvement program (PI). Additionally, there is concern about the National patient Safety goals to improve Healthcare equity.
5. The health plan offered to employees is getting more expensive each year. In fact, the costs are increasing at a rate of 20% each year. This is adding significantly to the hospital’s operational costs.
6. The inpatient mental health services and neonatal intensive care unit continue to lose money for the hospital.
Your Role/Assignment
The board of directors has asked that you provide a 750-word report (double-spaced in
APA format) detailing your strategies and recommendations to improve the financial
performance, address the Joint Commission concerns in PI and healthcare equity as
related to DEI, and quality and access of the hospital by focusing on the mental health
unit. The strategies and recommendations should be as specific as possible and include
identifying resources that are necessary to implement the strategies. You will use the
report template provided which is inclusive of identifying the issue/s, strategy for
improvement, and recommendations. The report should describe the outcomes
expected from implementing your recommendations. Your primary text and journal and website research must be used as a reference to support your analysis. Use at least three references listed in proper APA format.
Key Players
Dr. McCrae: Psychiatrist
I am a psychiatrist and admit my patients to the mental health inpatient unit at
Middlefield. It is the only psychiatric inpatient unit available in the community, and the
care provided is excellent. I understand the program loses money, but the hospital has
a community obligation to offer services to patients who need mental health care.
Aretha Holly: Pharmacy Technician
I love the health plan offered by Middlefield Hospital. The plan really meets the needs of
my family. The copays and deductibles are so low and I get my prescriptions for free.
Also, I can go to any provider I choose. I hope they don’t make any changes to the plan,
because I am worried that I may not be able to afford it.
Barbara Seville: Director of Quality Improvement Middlefield’s quality improvement activities are not effective anymore. We do lots of data
collection and reporting, but there is little improvement in the quality of care. Most staff members believe that we already provide quality patient care and don’t see why we are putting resources into this function. I think we are relying too much on our past
reputation.
Regional Hospital
Scenario/Summary
You are the chief executive officer of Regional Hospital, which serves a community of 875,000 people throughout the Charlotte-Mecklenburg area of North Carolina. In order to improve health
outcomes and reduce costs, you are reviewing proposals to contract with a disease management company. Several disease management companies have submitted their proposals to you for review.
Your Role/Assignment
The board of directors has asked that you provide a 750-word report detailing your strategies and recommendations to contract with a disease management company in order to reduce utilization costs and to improve patient health outcomes. Your report should outline the specific interventions and model that will be used by Regional Hospital. Your presentation should also explain cost projections and savings over a 10-year period. The strategies and recommendations should be as specific as possible and include the resources needed for implementation. A
minimum of three references are required for this assignment (our textbook along with two other scholarly sources). Our primary text and journal and website research must be used as references to support your analysis. Don’t forget to cite all references.
Also be sure to review the Grading Rubric to ensure that your paper satisfies all of the guideline criteria before submitting your finished paper as a Word document for grading.
Key Players
Review the points of view of the following people to obtain further insights on this assignment.
Previous
Ms. Jones, Health
Education Specialist, Eastern Disease Management
I have been a health education specialist for chronic diseases with Eastern Disease Management for the past 2 years and work with patients and physicians to promote interventions and communication.
Mr. Smith, CEO of Eastern Disease Management
I have been providing disease management services to hospitals for 20 years and offer
a full line of services, including mailing and calling both patients and physicians.
Play00:00
Mute
Ms. Abbott, Disease
Management Specialist, Regional Hospital
I have been working with the disease management department at Regional Hospital for 5 years, and utilization has continued to increase although the nurses in the department work directly with the patients.
Go to the Centers for Medicare and Medicaid Services website (CMS.govLinks to an
external site.).
Click on one of the articles. Analyze pay for performance quality and incentives in
hospitals, nursing homes, or provider offices and describe the performance standards
and scoring methods.
Your written paper should be 750 words, double-spaced, and in APA style. Our primary
text and the journal or website research article must be used as references to support your analysis paper. You must use at least three professional references. Include a link
to the primary article selected for this assignment.