Assignment: Adjustments to Transitions in Health Care Delivery

Assignment: Adjustments to Transitions in Health Care Delivery
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Consider what you’ve learned so far about the transition from volume- to value-based reimbursement. Different organizations will respond to the impact of this change in various ways. Based on its actions, an organization may flourish, or it may fail as its reimbursement decreases. As reimbursement methodology changes, institutions must adapt.

To prepare for this Assignment:

Read Case 5: Middleboro Community Hospital in this week’s Learning Resources, and consider the actions taken by this organization. Review data tables regarding their case mix (top DRGs), Patient Days, and CMS Core Measures. These metrics address both qualitative and quantitative measures in this organization.

The Assignment:

Write a brief, 2-page executive summary of the impact of the transition from volume-based to value-based health care. Specifically, address how this change in reimbursement methodology impacts operational requirements and how it can be implemented. Recommend at least two adjustments to operations which may position the organization for success under value-based health care.

Assignment: Adjustments to Transitions in Health Care Delivery

Consider what you’ve learned so far about the transition from volume- to value-based reimbursement. Different organizations will respond to the impact of this change in various ways. Based on its actions, an organization may flourish, or it may fail as its reimbursement decreases. As reimbursement methodology changes, institutions must adapt.

To prepare for this Assignment:

Read Case 5: Middleboro Community Hospital in this week’s Learning Resources, and consider the actions taken by this organization. Review data tables regarding their case mix (top DRGs), Patient Days, and CMS Core Measures. These metrics address both qualitative and quantitative measures in this organization.

The Assignment:

Write a brief, 2-page executive summary of the impact of the transition from volume-based to value-based health care. Specifically, address how this change in reimbursement methodology impacts operational requirements and how it can be implemented. Recommend at least two adjustments to operations which may position the organization for success under value-based health care.

 

Middleboro Community Hospital (MCH)

Middleboro Community Hospital (MCH) was founded as a shore-term, general acute care nonprofit hospital in 1890. Originally built with a 40-bed capacity, it has slowly grown to its present 272-bed size and has added a significant number of outpatient services. MCH is licensed by the state, incorporated as a 50l(c)3 nonprofit corporation, accredited by The Joint Commission, approved by the American College of Surgeons (cancer program), approved for Blue Cross participation, certified by the US Department of Health and Human Services for participation in Medicare, and accepts Medicaid patients. The Joint Commission recently granted a five-year accreditation based on periodic surveys. Current services, as indicated on the most recent survey by the American Hospital Association, include the following: • Airborne infection isolation room

  • Auxiliary organization • Bariatric/weight control services
  • Birthing room, LDR room, LDRP Room • Cardiac intensive care ·
  • Cardiac rehabilitation • Extracorporeal shock wave lithotripter • Health fair
  • Community health education • Health screening • Health research
  • Hemodialysis • HIV/ Al DS services • Multislice spiral computed tomography

HISTORY AND PHYSICAL STRUCTURE

Since its construction, MCH has been a model of hospital engineering and community interest. The hospital replaced three area homes used for the care of the sick. Today, the hospital is a fully air-conditioned, five-floor brick facility on a 68-acre campus. Ample parking is provided. Over the years increasing service demands required additions co the original structure. Each time these additions were built, existing facilities were modernized. Fund-raising campaigns raised the majority of resources for additions completed in 1924 and 1946. Federal Hill-Burton funds were used co partially finance the 1952 and 1966 additions. The 2002 building program relied on retained earnings, community philanthropy, and long-term borrowing. In 1919, this hospital founded a school of nursing to train area personnel. This three-year diploma school was one of the largest in the state and trained many of the nurses . .. . . ….

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