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This Tutorial contains 2 Papers
You have been the CEO of Middlefield Hospital for 2 1/2 years and
finally resolved the workforce challenges that plagued the hospital when
you first arrived. In a recent meeting, the chief financial officer (CFO)
indicated that the financial performance of the hospita l has been
deteriorating over the last 6 months. 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.
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. 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. 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. The Joint
Commission survey is scheduled for next year, and there are significant
problems with the hospital’s quality improvement program. 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. The inpatient mental