Healthcare Administration 2 Assignment 1
Serenity3203THE DYNAMIC ENVIRONMENT OF HEALTH CARE
Chapter 1
Objectives
Describe the present healthcare environment.
Examine megatrends in the environment.
Address organizational survival.
Identify the role of the healthcare practitioner as manager.
Review the classic functions of the manager.
Define and differentiate between management as an art and a science.
Conceptualize the characteristics of an effective manager.
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Megatrends
Client characteristics
Professional practitioners and caregivers
The healthcare marketplace and settings
Applicable laws, regulations, and standards
The impact of technology
Privacy and security considerations
Financing of health care
Social and cultural factors
Healthcare Regulation
State licensure laws for facilities
State licensure laws for professions
State-mandated healthcare planning
State laws governing reimbursement and insurance
Healthcare Regulation
Federal laws governing reimbursement
Federal laws regarding privacy and security of information
Patient Protection and Affordable Care Act
American Recovery and Reinvestment Act
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Reimbursement and Payment
Charitable roots and the not-for-profit model
Fee-for-service
Health insurance: Non-profit and commercial
Managed care
Current legislation: Healthcare reform
The Managed Care Era
Providing access to quality care at affordable cost
Primary care physician as “gatekeeper”
Premium costs by limits on services
Arrangements between managed care groups and hospitals
Issues about denial of service or payment
Capitation
Reimbursement system under which provider is paid specific amount of money to look after all the healthcare needs of a given population
Literally, reimbursement based on so much “per head”
Reasons for Restructuring
Desire to achieve greater negotiating clout
Desire to penetrate new markets
Need for improved efficiencies
Desire to express an overall value of promoting comprehensive, readily accessible care
Mergers and Affiliations
MERGER: Two or more corporate entities blend to create one new organization
AFFILIATION: Formal agreement between facilities to coordinate and share activities while remaining separate corporate entities
Range of Service
Note the variety of services and levels of care
Examples:
Adult day care center
Hospice
Urgent care clinic
Impact of Technology
“eVisits” and “digital doctors”
Translational medicine
Data warehousing
Data mining
“Real-time” interventions
Common language and standards: Standard vocabulary and classification systems
National information infrastructure: To capture, access, use, exchange, and store data
Increased use by patients of alternative therapies and interventions
The embedded nurse representative on patient care teams
Rationing; quality-adjusted remaining years
Social and Ethical Factors
Unit supervisor; project manager; department head
Specialized division head
Manager of independent practice
Role of Healthcare Practitioner as Manager
Management Functions
Typical management functions include:
Planning
Decision making
Organizing
Staffing
Directing or actuating (motivating)
Controlling
Effective Managers
Characteristics of effective managers include:
Knowledge of the internal structure and characteristics of their organization
Knowledge of the internal and external dynamics of their organization
Leading and motivating the workforce
Engaged in continuous search for excellence
Aware of and responsive to trends and challenges
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