Financial Management in Healthcare

Based on the hospital’s surrounding challenges, I am obligated as CEO to take the required safeguards to ensure that I provide great health care while not incurring losses. As CEO, I will ensure that the staff focuses on patient-centeredness because it leads to quality health care, ensuring that the majority of patients receive their medical needs. Patient-centered care means delivering care that is responsive to the patient’s needs and values (Gruen & Howarth, 2005). This type of care model will ensure that the majority of patients from low-income areas are well-treated and receive quality health care, hence improving their health. Based on that, they will not strain the hospital and as such loses will be prevented.

The policy of efficiency will become part of the hospital, and I will ensure that all the personnel are trained on how they can offer their services both effectively and efficiently. Efficient staff ensures that the hospital equipment, ideas and energy are not wasted and as such that will prevent loses. Handling everything in the hospital with lots of care starting from the reagents that are expensive will reduce the cost spent on buying such materials (Wrightson, 2002). Effectiveness in this scenario refers to the provision of medical services based on scientific knowledge that could be helpful to the patient and not provision of what they do not benefit from (Gruen & Howarth, 2005).

Time is one of the important resources and due to that, to minimize losses, there is need to initiate a patient tracker that depicts the amount of time the patient spends in the hospital and evaluates whether it is necessary. Harmful delays in the hospital could lead to more costs that will burden the hospital budget. Insisting on the safety of both the treated patients and the staff prevents unintended injuries that could lead to unnecessary costs.

2.

Managed care organizations (MCO) mainly refers to health care providers that offer managed health care plans. The organizations are similar because they are all certified by the Department of Consumer and Business services (BCBS). They, however, vary based on the constitution that guides their operations as some comprise of physicians and doctors while others a combination of both and other health care providers (Kongstvedt, 2009).

Preferred Provider Organization (PP0) which is one of the MCOs refers to an agreement in which a third party makes a contract with a group of health care providers who provide the services for an agreed payment. In this form of MCO, the services that are provided are discounted: however, the insured individual might be forced to pay out of pocket payments for the services that are received outside the PPO.

Health Maintenance Organizations (HMO) on the contrary offers comprehensive health coverage for the physician and hospital services, unlike PPO in which the patient is forced to take charge of the expenses not covered. The models of operation used in HMO differ from PPO as it mainly focuses on group practice, network, staff and IPA.

PPO involves the use of a third party to make contracts while HMO operates on various models that ensure the client benefits. Both the two managed care models focus on the welfare of the patients by ensuring physical examinations is done to them (Kongstvedt, 2009). PPO gives a provision for the members to pay outside the network, unlike HMO in which an individual pays internally based on the model they chose. Both the MCOs have the “gate keeping” aspect in which the primary health care provider decides if the patient is allowed to get further directives or not.

3

My health insurance is Emblem health. The insurance is one of the best based on the package that comes with it. The objective of Emblem Health is to develop a consumer-centered technology that gives the people access to health care education and information that can help them make right decisions. Such shows the insurance is concerned towards the wellbeing of the clients.

The health care exchange educational website makes it one of the best. From the website, one can get information on matters about health care and how they can best join. Because the price is an important tool, the insurance company developed a group plan that can assist the clients in planning comparison tools. The cost calculators help in all the segments. The events organized by the insurance company aim at championing health care, and due to that, it is one of the best.

The customer acre service is prompt and responds in time to urgent matters. The packages offered such as the small business in which small scale business people are given group coverage makes it one of the best. I, however, do not like the fact the fact that it offers a wide range of plans that mainly benefit the wealthy at the expense of the poor people. I do not like the Medicare policy which appears convenient to many people because it provides the chance of the company taking advantage of the clients.

References

Gruen, R., & Howarth, A. (2005). Financial management in health services. Maidenhead, England: Open University Press.

Kongstvedt, P. R. (2009). Managed care: What it is and how it works. Sudbury, Mass: Jones and Bartlett Publishers.

Wrightson, C. W. (2002). Financial strategy for managed care organizations: Rate setting, risk adjustment, and competitive advantage. Chicago, Ill: Health Administration Press.