HealthcarePractices

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School

American Sentinel University *

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Course

520

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Business

Date

Apr 3, 2024

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Uploaded by mizpebbles

Running head: HEALTHCARE PRACTICES 1 Healthcare Practices American Sentinel University HCA520

HEALTHCARE PRACTICES 2 Healthcare Practices Baptist Hospitals a 406-bed hospital that resides in Texas. Many services are offered in the facility that include Emergency Room Services, Surgical Services, Women and Children Services including a Level II- Neonatal Intensive Care and Inpatient Rehab. Accompanying the acute care hospital are Psychiatric Services for children and adults on an inpatient basis as well as a Cancer Centre that provides treatment on an outpatient basis. Baptist Hospitals accepts all forms of insurance for inpatient care, surgical services as well as, psychiatric and all cancer services. Baptist Hospital is an urban facility with approximately 396,592 residents that may seek out care in the facility . While reviewing the reports for 2018, they show that inpatient self-pay admissions were 8% and self-pay Emergency Room visits were 24%. The fiscal year reports are from July 1, 2017-June 30,2018. Charity care is also available in the facility for which help is provided by the case managers to investigate if a patient qualifies. Rates for patients receiving charity care vary and are usually lower than in patient and emergency room numbers, this due to patients not meeting the requirements and qualifying for charity care. Case mix trends are shown over the past six months vary slightly. The case mix volumes are divided into two categories. The first being a total case mix volume with a six-month range of 1.5684-1.7067. A second report shows the six-month trend for Medicare with a range of 1.6034-1.7840. The six-month report shows a higher volume of Medicare patients in the facility with the highest trend in November 2018. Operational report indicates a positive margin over the past six months. This is based on the following categories Medicare, Medicaid, HMO/PPO, Self-Pay and Indemnity/Other.

HEALTHCARE PRACTICES 3 Reviewing the financial reports for February 2019, it was noted that the greatest loss in revenue was related to indigent care. Indigent care was budgeted in for the fiscal year 2019. With cuts made in healthcare, Baptist Hospital was required to make large cuts due to the denial of greater then 13 million dollars to the current years budget. Departments facility wide were required to find cost savings that could offset the monetary loss. Cutting costs in each department has proven difficult as certain services could not be adjusted due to contractual agreements. Staff positions were to be the last cut and although most departments did not see any staff reductions, contracted services such as housekeeping were required to cut staff and transporters. Cuts such as these have increased the workload on the floor staff, causing frustration due to added daily duties. Payor mix greatly affects the financial status of the hospital as seen in the six-month trend report provided by the Chief Financial Officer (CFO). In this report, it is noted that net revenue compared to prior year shows a 20% reduction from the same month as the prior year. Insured patients are certainly not guaranteed, and it is very difficult to project admissions each year. Budgeting for these variations is vey difficult causing a variation in payments to the facility. An example shown in the financial report is an increase in Health Managed Organization patients. Compared to prior year there was a ten percent increase in this specific category of insured patients. The financial status of the facility will fluctuate slightly with patient admissions, surgeries and emergency room visits; however, the overall financial status of the hospitals has remained about the same with little change seen in uncompensated care reimbursements. Texas has not expanded its Medicaid program under the Affordable Care Act (ACA), and with a large amount of uninsured in our area, this leaves the facility providing care for patients

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HEALTHCARE PRACTICES 4 that are unable to pay for services. According to the CFO this has impacted the facility with many patient bills left unpaid and requiring the facility to write the costs off to bad debt. Healthcare is in a constant state of change and is evolving each year since the enactment of the ACA. Changes require each facility to adjust the services they provide according to what is set out by each insuring agency. Healthcare has improved greatly with the enactment of pay for performance and has defiantly changed the way hospitals and doctors provide care. Patients are able to choose the facility they receive care form and will continue to seek out the best value for their dollar.

HEALTHCARE PRACTICES 5 Source Gary, CPA, MBA Chief Financial Officer, Baptist Hospital Ryan MBA, Financial Analyst, Baptist Hospitals

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