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Final Project Submission: Policy Research and Organizational Analysis Report
Name
Date
1.
Introduction
I have decided to evaluate Johns Hopkins Medicine for my final project research. JHM is
a Baltimore, Maryland-based, $8 billion comprehensive global health organization (Johns et al.,
2017). JHM is a pioneer in the US healthcare industry thanks to its innovations and commitment
to enhancing the general health of its residents.
For all of their patients, they exhibit the greatest
standards in clinical treatment, health education, research, and care. As an educational institution,
they are tasked with caring for their patients to the highest standard while educating the future
researchers and doctors of America and other parts of the globe.
JHM is divided into two segments: nonprofit and for-profit. The organization's for-profit
margins comprise its various enterprises, whereas Johns Hopkins Medicine is its nonprofit
division. The Johns Hopkins Bayview Healthcare Center, Howard County General Hospital,
which is part of Johns Hopkins Hospital, Johns Hopkins Health Care Corporation, and Johns
Hopkins Medical Administration Corporation are other companies that belong to the JHM group
(Akbari et al., 2022)
. The Johns Hopkins System Company (JHHSC) is the umbrella organization
under which these organizations operate.
JHM is the industry leader in the US and Baltimore, with over 125 years of expertise in
healthcare research, education, and medical services. The reality that Johns Hopkins Healthcare
Institutions are composed of profitable and not-for-profit entities significantly impacts how
policy changes, particularly economic ones, are adopted. Their overall net income in 2018 was
close to $48 million in profitability
(Oronce et al., 2020).
2.
Economic Theories and Principles
a. Economic Disparities
There are numerous disparities in the market for health care due to differences in
ethnicity, race, income, and education. A lack of education and substandard living conditions,
such as residing in low-income accommodation, can hurt one's health. Meaningful progress will
likely be made in reducing health disparities by addressing the fundamental causes
(Akbari,
., &
Hopkins, 2022)
. These fundamental causes are impacted by education, caregiving, employment,
community and economic revival, transport, housing, and land use policies, which affect health
and medical expenditures. To fully understand the health disparities, we must examine various
aspects of health in depth, particularly sex, age, and heredity
(Khanijahani, 2021)
. Additional risk
factors influence health, known as downstream determinants, which are influenced by societal
conditions. These variables consist of medical services, environmental factors, and health-
promoting behaviors.
Numerous social determinants, such as schooling, financial standing, and social context,
lead to conta t with such factors. Individuals' exposure to contaminants, including poor air
quality and smoking, and their failure to adhere to treatment guidelines are influenced by their
living environments
(O once et al., 2020)
. These conditions affect their exposure to environmental
health hazards and change their health behaviors, leaving them more susceptible to illness, with
less access to care and an inability to handle their health issues at home. However, social factors
are frequently the root cause of many diseases and are essential to understanding numerous
health disparities.
b. Economic Theories
Unfortunately, healthcare is expensive, whether you are a patient or a student studying to
become a healthcare professional. This is primarily because of the cost of technology. As the
healthcare industry continues to develop, more technology is required to develop operations,
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tools, and medications. Significant government funding within taxpayer-funded government-run
insurance programs and revenue from taxes to private health insurance coverages enables
medical providers to continue utilizing technologies that consumers and patients may consider
less expensive. The economic theory presupposes that any government intervention to encourage
the use of particular services or goods is undesirable
(Akbari,
., & Hopkins, 2022)
. Without
subsidies, people will consume what they consider to be the optimal amount of various goods. A
subsidy for the consumption of hamburgers, for instance, encourages excessive consumption of
hamburgers compared to different products. There is an exemption for this rule for products that
some consumers eat to benefit others. If, for instance, individuals would not receive polio
vaccinations unless they were subsidized or mandated to do so, there would be a strong case for
subsidizing or mandating polio vaccinations
(Khanijahani, 2021)
. However, the vast majority of
healthcare expenses are currently devoted to private services which solely benefit the recipients
c. Use of Economic Principles
Unfortunately, those in the healthcare sector have been subjected to constant
requirements and constraints, such as forced budgets and diminishing assets. Evidence-based
public health (EBPH) must be a vital component of the decision-making process to improve
patient outcomes and reduce expenditures for patients and the institution in question. Evidence-
based integrates empirical reasoning into the execution, development, and assessment of
successful policies and programs inside the broader public health professions
(Khanijahani, 2021)
.
Evidence-based public health employs the best evidence at hand while also considering the
demographics and features of toleration to forecast and evaluate an initiative and estimate costs.
In evidence-based public health, financial proof is crucial because it provides insight into the
worth of every health-related initiative throughout the healthcare system. In response to the
collected data, replacing and boosting investments in health system improvements and
preventative measures may generate long-term health gains.
3.
For Profit and Nonprofit
a.
Financial Differentiation
A for-profit organization's ultimate purpose is to earn a profit, but its mission aims to
achieve the opposite; irrespective of profit, it would want to accomplish its goal of serving and
aiding society as a whole in improving its quality, which promotes happiness and improved
health. For-profit corporations may spend their revenue in a variety of ways. They can retain all
their profits and continue to develop, or they can spend the bulk of it on the firm itself. Other for-
profit firms may share their earnings with the personnel who earned them in the first place via
different pay and profit-sharing arrangements
(Akbari,
., & Hopkins, 2022)
. On the other hand, a
nonprofit organization is solely concerned with the monetary worth of maintaining the
organization viable and working to the best of its ability.
When it comes to guidelines, regulations, companies, and policies vary from state to
state. Regarding funding nonprofit organizations, several states provide structures like
unincorporated corporations or trusts, which enable a nonprofit organization to function under
somewhat different conditions. The major contrast between nonprofit and profit-driven
businesses is how they get r sources and funding. Nonprofit organizations must serve the
community's health care requirements so that they are exempt from taxes and may reinvest that
money in their business to support people in need, like free care programs and low-cost
assistance programs for low-income persons
(Akbari,
., & Hopkins, 2022)
. Whereas that-profit
healthcare systems may benefit from money invested in them by investors, they have many more
alternatives and freedom with the services they can give and the prices they might charge to
discover the most lucrative ones for them.
b.
Economic Differentiation
In terms of law and policy, there are several legal distinctions between for-profit and
nonprofit healthcare businesses. In recent years, the number of for-profit enterprises in
healthcare, notably for-profit hospitals, has increased. Many traditional conventions and concepts
within the healthcare sector and certain people within the industry, notably doctors, have been
challenged due to this transition. With the corporate reorganization that many nonprofit hospitals
have undertaken, the gray area separating nonprofit and for-profit medical facilities has grown.
In most cases, a single-hospital corporation evolves into a holding business with various
affiliates, including the hospital. Depending on the operation, each company could be investor-
owned or charitable. Nonprofit hospitals, nevertheless, lag behind investor-owned institutions in
this area. Because commercial companies are controlled by their shareholders, combining them
into a single multi-corporate organization under the supervision of a holding business that
controls all of their stock is quite simple (Keith, 2021). Furthermore, as previously indicated,
moving resources across parent and subsidiary company entities is quite simple.
4.
Disparities and Policy Changes
a.
Economic Policy and
Disparities in Care
Variations that take place and are present within diverse groups of individuals are known
as health disparities. Gender is one of the most significant differences in healthcare, and although
some of these discrepancies are biological, the vast majority are not. These non-biological
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differences stem from socioeconomic factors influencing people, such as drug addiction,
psychological wellness, brutality, dependency on alcohol, and death rates
(O’Connor et al., 2021)
.
One method to successfully address this discrepancy in healthcare is for healthcare practitioners
to enable both men and women to participate in health education.
LGBTQ Differences are another important healthcare aspect that must be addressed. This
demographic is susceptible to not just all other ailments that ordinary people may encounter but
also to more particular diseases, including AIDS or HIV. For some time now, the spread of HIV
and AIDS has been a prominent focus of study inside the LGBTQ sector of healthcare; there is
additional research that demonstrates inequities among women belonging to this sexual minority
(O’Connor et al., 2021)
. They claimed inadequate physical and mental wellness and increased
access to and consumption of healthcare. Discrimination, societal stigma, and individual bias
may contribute to these discrepancies. In economics, members of the LGBTQ population who
live at or below the socioeconomic poverty line are frequently less healthy than individuals who
are more financially secure (Keith, 2021). There was a huge social stigma connected with both
persons that belong to this group in the past, and although that has substantially decreased,
particularly in recent years, they still face some prejudice.
b.
Policy Changes
Medicare and Medicaid, as well as the Affordable Care Act, were established in 1965.
The law known as the Affordable Care Act represents one of the most important pieces of
healthcare legislation ever passed in the nation's history because the legislation was capable of
carrying out a wide range of changes that improved not solely the affordability of care but also
ensured that it was fairly replaced while ensuring the overall quality of care was substantial.
Those in charge of policymaking ought to expand on the Affordable Care Act's progress by
continuing the implementation of the Health Care Insurance Marketplaces as well as system
reform, boosting the amount of federal funding for Marketplace participants, incorporating a
publicly funded plan option in areas where individual competition in the market is lacking, and
taking steps to lower drug prescription costs
(O' Connor et al., 2021)
. Although politics and special
interest resistance persist, the Affordable Care Act proves that meaningful change addressing
some of the nation's most difficult concerns is possible.
c.
Disparities Planning
Even though ongoing attempts are made to assist in eliminating inequalities, they can
only partially be removed. Hence, they are considered in the long-range strategy that comes into
medical facilities. Disparities in health care across ethnic and racial backgrounds are among this
country's most significant contributing factors (Keith, 2021). Though we might expect these
inequities to be eliminated, they are currently highly prominent. To keep trying our best to
eliminate these inequities, we must ensure more fairness and transparency within healthcare
institutions. Sadly, we are still correct despite significant internal changes. In our nation,
ethnicity, and racial background play a role in determining whether a person gets treatment and,
if so, the quality of that care. We are all human, so we all need the best possible treatment.
Ethnicity and race should not serve as factors in the care we get.
5.
Organizations Impact and Recommendations
a.
Organizational Introduction
Johns Hopkins Hospital is a more than eight billion-dollar worldwide health organization.
JHM is a pioneer in the US healthcare industry thanks to its innovations and commitment to
enhancing the general health of its residents (Johns et al., 2017). For every one of their patients,
they exhibit the greatest standards in clinical treatment, health education research, and care. As
an educational institution, they are tasked with caring for their patients to the highest standard
while educating the future researchers and doctors of America and the rest of the globe.
b.
For-profit or Nonprofit?
JHM is divided into two segments: for-profit and nonprofit. The organization's
commercial margins comprise its various enterprises, while Johns Hopkins Medicine is its
nonprofit division. The Johns Hopkins Bayview Healthcare Center, the county's General
Hospital, which is part of Johns Hopkins University Hospital, Johns Hopkins Medical Services
Company, and Johns Hopkins Medical Administration Corporation are other companies that
belong to the JHM group. The Johns Hopkins System Company (JHHSC) is the umbrella
organization under which these organizations operate (
Irvin, 2019).
Due to the company's size,
every economic policy will uniquely affect how they employ strategic planning to be ready for
the constantly changing regulations being presented every year.
6.
Financials, Market, and Demand
a.
Demand Theory
JHM is the industry leader in the US and Baltimore, with over 125 years of expertise in
health education, studies, and medical services.
Because Johns Hopkins Medical Facilities are
comprised of for-profit and nonprofit organizations, it significantly impacts how changes to
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policies, particularly economic ones, are adopted. Their overall net income in 2018 was close to
$4
million net profit. Sadly, the US government has a large role and effects on healthcare
pricing; therefore, demand and supply are not the only variables that affect healthcare costs
(Bevais et al., 2019)
. Even though they are not formally establishing healthcare sector pricing, they
are exerting pressure on the country's healthcare systems and focusing it on price adjustments.
According to JHM's fiscal year 2015–2016, there is no evidence. Patient care revenue
recorded in the fiscal year ended June 30, 2016, inclusive of contract allowances (but before
funding for bad debts), from these key payer suppliers, is as follows: Payer Source: Third party
$5,195,483, self-pay $98,959, total $5,195,442 (net of contractual bonuses
(Beauvais et al., 2019)
.
Patient care income from these significant payer sources recorded in the year ended June 30,
2015, inclusive of contract concessions, but without paying for bad debts, is as follows: Payer
Source: $4,991,376 (the net amount of contract allowances); self-party: $77,601; the d party:
$4,913,775. 2017 JHHS FY16
b.
Effects of Market Behavior
The market will significantly impact the hospital's accounts payable during the year since
only some insurance plans have the same effective dates and limitations. Due to the reality that
healthcare registration dates vary depending on when the coverage is introduced, the Affordable
Care Act may hurt the accounting records (Keith, 2021). The relationship between supply and
demand also significantly impacts market behavior since the cost of implementing new medical
treatments may increase significantly due to both their demand and availability. Due to the
influence and potential damage that pharmaceutical and medication firms may inflict due to their
monopolistic power position, they can also have a detrimental impact on the market for
organizations.
7.
Economic Legislative Changes
a.
Legislative Changes
Due to the passage of the Health Insurance Portability and Accountability Act of
2014 and the enactment of the Affordable Care Act, the JHHSC has discovered the need
to adjust its policies. The federal government implemented the Affordable Care Act to
eliminate healthcare inequalities, and it has recently been extended to accommodate
residents with higher incomes who would not have previously qualified for this program.
With the adoption of HIPAA, preventative strategies were developed to stop prejudice
against patients with pre-existing diseases who could not be approved for health
insurance (Keith, 2021). HIPAA also requires healthcare businesses to have backup
procedures ready for their medical data to guarantee that all patient private and medical
information is secure inside the system and linked to all doctors participating in their care
teams.
b.
Policy Changes and Their Impact
The implementation of the Affordable Care Act and HIPAA has had an impact on
several JHHSC policies in various areas of their company. Patient registration,
verification of insurance, collecting payments, revenue generation, the two-step check-in
and checkout procedures, and absent and cancellation rules are all examples of these
components. The policies described above had to undergo and endure revisions to
completely conform to the new laws enacted with these acts
(Moglia et al.,
., & Bardoel,
2021)
. The most significant shift in their approach was how healthcare data was given so
that their patients' information was safely guarded at all costs. Johns Hopkins must
constantly update its organizational rules to conform to the requirements established not
only by law but also by payers and insurance organizations to maximize the money
obtained for service. Regarding reimbursements it is an obligation under the Affordable
Care Act law.
c.
Impact Statement
When healthcare regulations change, so do the processes. This new law requires
collecting payments, copays, and deductibles in advance. This will disclose the financial
effect of the decreased accounts receivable. Conversely, this will result in fewer payment
rejections from commercial payers and a much more effective procedure for the health
insurance authentication, registration, and billing process that the front desk and registrar
personnel deal with regular
ly (Mi chell et al., 2023)
. Another benefit of this approach is that
it will result in fewer mistakes and a cleaner submission to creditors for the organization
to get reimbursement for services delivered.
d.
Potential Disparities
The ultimate objective of the Affordable Care Act is to eradicate healthcare
inequalities by providing expanded access, healthier work environments, better nutrition,
and better educational opportunities and housing for everyone. Over the past decade, we
have identified what works and what does not impact the daily lives of these folks, both
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in terms of health and finances, by consistently improving these discrepancies
(Mandelbaum, 2022)
. All personnel in the healthcare industry, as well as members of the
community at large, should be active in eliminating gaps not just throughout the medical
field but also in the community. Working collaboratively, strategic objectives may be
formed to address these gaps and align them with the business's vision and goals and the
people who contribute to making the business what it is.
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