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Overview

 

Assignment	Due Date	Format	Grading Percent
Finance, Risk, and Cost	Day 3 (1st post)	Discussion	6
Overinsured, Underinsured, and Uninsured	Day 3 (1st post)	Discussion	3
Feasibility Study Topic and Area of Interest	Day 7	Assignment	8

Learning Outcomes This week students will:

1. Discuss common approaches to managing risk.

2. Create an investment scenario for a potential health services project.

3. Discuss the relationship between cost and quality.

4. Examine major trends in health insurance.  

Introduction

Understanding and managing costs and risks are core administrative tasks. Regardless of the mission of the health organization, leaders must consider cost control a priority. In addition, they must be able to make decisions even when important information is incomplete or missing. When leaders do not have all the necessary data, they must appraise the risk to determine if it is worth taking and what the best strategy for dealing with it might be. In light of this, insurance is all about managing risk. It is important for leaders to understand how it is structured in both private and public settings.

This week we will be determining the risk and assessing the cost of a proposed venture. You will have the opportunity to take on the role of the presenter as well as that of the reviewer, which will allow you to experience two professional perspectives on the same problem. You will also be delving into the implications of accessibility and distribution through the lens of health insurance.

Required Resources Required Text

1. Lee, R. H. (2009). Economics for health care managers (2nd ed.). Chicago, IL: Health Care Administration Press. 

a. Chapter 3: An Overview of the Healthcare Financing System

b. Chapter 4: Describing, Evaluating, and Managing Risk

c. Chapter 5: Understanding Costs  

Articles

1. Daniels, E. B., & Dickson, T.C. (1990). Assessing the feasibility, Performance of geriatric clinics. Healthcare Financial Management, 44(2), 30-34. Retrieved from the ProQuest database

· This article will be used in conjunction with your feasibility study assignments.

2. Democratic Policy & Communications Center. (n.d.) The Patient Protection and Affordable Care Act [PDF].

· This online report is the U.S. Senate’s version of pertinent facts related to the Affordable Care Act.

3. Leff, B., Burton, L., Mader, S., Naughton, B., Burl, J., Greenough, WB., …Burton, J. R. (2005). Hospital at home: Feasibility and outcomes of a program to provide hospital-level care at home for acutely ill older patients.  Annals of Internal Medicine, 143(11), 798-808. Retrieved from ProQuest database. 

· This provides an example of a feasibility study.

Recommended Resources Articles

1. The Access Project. (2001). A community leader’s guide to hospital finance: Evaluating how a hospital gets and spends its money. Retrieved from http://www.accessproject.org/downloads/Hospital_Finance.pdf

· This article provides a community or systems perspective on how hospitals receive payment and spend money for services to maintain operability of an organization.

2. Custer, W. S. (2013). Consumer choice in health insurance. Journal of Financial Service Professionals, 67(4), 25-27. Retrieved from the EBSCOhost database.

· Custer (2013) states that “Tthe health insurance market is likely to become more complex with full implementation of the Affordable Care Act. There is a good deal of research that suggests that consumers' choices may not be rational when the number of alternatives is large, the alternatives are complex, and information is limited or costly. Overcoming the limitations in consumer decision making requires reducing complexity, increasing information, and providing computational resources.”

3. Dhingra, S. S., Zack, M. M., Strine, T. W., Druss, B. G., & Simoes, E. (2013). Change in health insurance coverage in Massachusetts and other New England states by perceived health status: Potential impact of health reform.American Journal of Public Health, 103(6), e107-e114. doi:10.2105/ AJPH.2012.300997  The full-text version of this article can be accessed throguh the EBSCOhost database in the Ashford University Library.

· This article examines the impact of health reform in Massachusetts and its public health component (enacted in 2006) on change in health insurance coverage by perceived health.

4. Fottler, M. D., & Lanning, J. A. (1986). A comprehensive incentive approach to employee health care cost containment. California Management Review, 29(1), 75-94. Retrieved from the EBSCOhost database.

· The article discusses the use of a comprehensive incentive approach to employee health care cost containment. A comprehensive approach would involve system controls to shrink the system as well as incentives for both providers and health care consumers to reduce utilization, be more price conscious, and provide services more quickly.

5. Mango, P. D., & Riefberg, V. E. (2009). Three imperatives for improving US health care. Mckinsey Quarterly, (2), 40-44. Retrieved from the EBSCOhost database.

· The article discusses actions that the author feels should be taken to address the high cost of health care within the United States.  Specific problems that the authors feel the U.S. government should address are discussed, such as the cost associated with treating diseases related to people's lifestyles and wastes within the health care system

6. Rohr, R. (2012). Cost control: The new frontier of medical management. Physician Executive, 38(4), 82-83. Retrieved from the EBSCOhost database.

· The article offers the author's insights regarding the medical care cost control in the United States. The author states that the Affordable Care Act has instructed a reduction in spending from the current levels. He says that the value-based purchasing will lessen total payments from the Centers for Medicare and Medicaid Services in the United States.  

Websites

1. Hospital Corporation of America (http://hcahealthcare.com)

· This is the main website for a major hospital system covering the United States.

2. Tenet Health System (http://www.tenethealth.com/pages/home.aspx)

· This is a competitor hospital health care system similar in size and scale to Hospital Corporation of America.

3. United States Department of Health & Human Services (http://www.hhs.gov/healthcare/rights/)

· This website offers information on the Affordable Care Act from the perspective of the U.S Department of Health and Human Services, which oversees it.

4. United States Department of Labor (http://www.bls.gov/ooh/healthcare/)

· The U.S Department of Labor provides an annual review of occupational health statistics as they relate to market forces.

5. Vaikom Hospital & Healthcare (http://vaikomhealthcare.com/project-cost-estimates)

· This website offers a sample of the basic tenants that go into a cost estimate and the breakdown of the variables.

Discussions To participate in the following discussions, go to this week's Discussion link in the left navigation.

1. Finance, Risk, and Cost Prior to engaging in this discussion, read Chapters 3 and 4 from the text review any relevant Instructor Guidance.  It is suggested that you review the recommended resources to glean any helpful information. You are an associate director in a 300-bed hospital located in an urban area. For the purposes of your presentation, the location will be the closest city to your current residence (this may be your city of residence). A sum of money is available for investment in the facility. You have been tasked by the hospital CEO to present a possible investment scenario in which you renovate your existing facility, expand the current facility, or clinically integrate your electronic health records (EHRs). There is only enough money to fund one of the potential projects. Your primary sources of data and information may or may not be reliable. Please see the “Finance, Risk, and Cost” document for the data needed to create your presentation.

In this discussion, you will be create a five-minute presentation using PowerPoint and Screenr wherein you propose one of the potential projects and defend its viability as the best option at the present time. Your PowerPoint presentation slides must include the following information:

· A basic design of the projected service/project (i.e., the option you are promoting)

· An analysis of the role of public policy in terms of your provision of health care services and provide justification of your choice

· An explanation of the relevance of the current financial data in terms of the projected outcome of the project

· A compare and contrast discussion of the economic challenges and incentives related to your project

Once you have created your PowerPoint presentation, use Screenr to create a screencast of your presentation with voiceover. Include a title for your presentation in the description box when you publish your screencast. Refer to the Screenr.com Quick-Start Guide for assistance. The hospital CEO has limited your presentation time to three to five minutes, so you will need to incorporate as many characteristics of an effective speaker as you can within this timeframe. These characteristics may include but are not limited to storytelling, facts only, pace, and volume. Since there is no video of the presenter (just the presentation itself), you will not have the benefit of body language, so be sure to create a convincing screencast. Do not read your slides; rather, elaborate on your bullet points and/or financial maps within the slides.

Copy and paste the URL to your screencast into your discussion board response section and attach your PowerPoint (.ppt) file to the post prior to submitting it. Your presentation must utilize at least two scholarly sources, in addition to your textbook, that are cited in APA format as outlined in the Ashford Writing Center. All sources used within the presentation must be cited properly on the slides and included on required reference slide, which will be the last slide of the PowerPoint presentation. Due to the time limit of your presentation, you are not required to speak or read through the reference slide. However, you must include your reference list within the discussion post along with the URL for your screencast and submit your PowerPoint presentation by attaching the PowerPoint (.ppt) file to your initial discussion post. 

Guided Response: Read several of your classmates’ posts and provide a substantive written response to at least two of your peers. Taking on the role of the hospital CEO, review the presentations provided by at least two of your peers. Evaluate the social issues that influenced the choice of project. Does the initiative match the mission and vision of the facility?  Does the presentation effectively defend the project in terms of financial impact on the facility? Will the project meet regulatory needs? Is the cost of the project worth the financial risk? Why, or why not? In addition to responding to at least two other students’ posts, it is recommended that you reply to at least one person who responded to your original presentation by either respectfully defending your conclusions or by listing how you might consider other alternatives.

2. Overinsured, Underinsured, and Uninsured  Prior to engaging in this discussion, be sure to read Chapters 4 and 5 from the textbook and review the information included in the “Patient Protection and Affordable Care Act” detailed summary, the information provided on the U.S. Department of Health and Human Services website, and any relevant Instructor Guidance.

Presently, the United States is a fragmented system that offers a misdistribution of “haves” and “have nots” which impact the cost of delivering health care. The United States is currently a nation of overinsured, underinsured, and uninsured people. In light of the passage of the Affordable Care Act (ACA), how do you see these issues being corrected so that a majority of the population has access to quality health care? In an initial post of 250-300 words, communicate the relevant aspects of the ACA that will impact these issues. Analyze and describe how the role of public policy will affect changes in this distribution.  Evaluate and explain some of the social-cultural issues that might present potential problems as this plays out across the country. What implications associated with the ACA might lead to a paradigm shift in the ways in which we view access to health care?

Guided Response: Read several of your classmates’ posts and provide a substantive written response to at least two of your peers. Did your classmates identify the same or different potential problems than you included in your post? How might you reconsider your original position based on the problems presented by your peers? What specific aspects of the paradigm shift did your classmates present that made you reflect differently on the potential outcomes of the ACA? Explain your reasoning.

Assignment To complete the following assignment, go to this week's Assignment link in the left navigation. 

Feasibility Study Topic and Area of Interest A detailed feasibility study is an essential element in the process of diligently assessing any new health services business venture. According to data released by the Bureau of Labor Statistics, the health care industry is currently one of the fastest growing fields in the United States, and it is projected that the field will grow by 22 percent by 2018. This is compared to an 11 percent average growth rate for all other industries (United States Department of Labor, 2012). Whether you are considering new medical service lines, an expansion of your current operation, or any other type of health care business venture, a feasibility study is an essential planning tool for any future health care leader.

In this assignment, you will be taking the first step toward the completion of your final assignment by settling on the topic for your feasibility study. Please read the Leff, et al (2005) article, “Hospital at Home: Feasibility and Outcomes of a Program to Provide Hospital-Level Care at Home for Acutely Ill Older Patients.” Reflect on the procedures and content found in the article to aid you in choosing and shaping a topic for your feasibility study. The topic you select should be of interest and meaningful to you and your career, and it must be related to health care delivery.

Create a document that includes the following:

· Title: Proposed title for the feasibility study

· Topic: Topic of the feasibility study

· Description: A brief description (250-500 words) of how the proposal will impact the quality, availability, accessibility, and affordability of care

· List of Resources: A list of five scholarly sources that you plan to use as you complete your feasibility study

Writing the Feasibility Study Topic and Area of Interest The Paper:

· Must be one to two double-spaced pages in length, excluding the title and reference pages, and formatted according to APA style as outlined in the Ashford Writing Center.

· Must include a title page with the following:

· Title of paper

· Student’s name

· Course name and number

· Instructor’s name

· Date submitted

· Must address the topic with critical thought.

· Must include the listed headings with the content required under each.

· Must use at least five scholarly sources that were published within the last five years, including a minimum of three peer-reviewed sources from the Ashford University Library.

· Must document all sources in APA style as outlined in the Ashford Writing Center.

· Must include a separate reference page that is formatted according to APA style as outlined in the Ashford Writing Center.