financial problems including recent healthcare reforms H e a l t h M e d i c a l

financial problems including recent healthcare reforms H e a l t h M e d i c a l

Please respond to this 4 peers’ Discussion Prompts

Peer# 1

Hello Everyone,

As any business grows, ethical issues can arise. Some ethical issues can be taking clientele from the company you work for as you grow your venture, reporting accurately the finances, partnerships, hiring and firing staff, and other entrepreneurs growing with your venture and starting their own businesses (Hisrich et al, 2017). One example of taking clientele can be a new doctor’s office opening in the area, and a provider going to the new practice. They could take their clients from the previous practice which could prove problematic for the patient depending on the insurance and reimbursement offerings of the new practice (Ahsan, 2018). Being able to accurately depict your finances to these insurance companies as the new doctor’s office can also cause issues with reimbursement practices on the state and federal levels (Harrington, 2016). If the incoming provider wants to have a partnership with the owner of the new practice, there can be issues with contracts being written in a way that both parties are able perform their duties and report accurately. As the practice grows, there can also be issues with hiring and firing staff under the providers, like nurses, medical assistants, respiratory therapists, etc. If the partnership doesn’t come to fruition, the secondary provider can even opt to move on and open their own practice, which begins the cycle again of bring patients, staff, financing, etc. to the new practice being opened (Ahsan, 2018).

As a healthcare manager these issues can be resolved in a number of different ways. Having the newly hired provider, and other staff, sign a contract about what is expected pre-, during, and post-employment. Hiring a financial company to assist with reporting necessary information is also a good way to prevent issues with the insurance reimbursement, or at the very least a financial expert that can assist with complicated financial aspects of a healthcare practice (Hisrich et al, 2017).

I look forward to your feedback.

Peer# 2

Hi everyone!

     Many times, we think of ethical breaches occurring the large, established companies with a multitude of employees, but ethical issues can arise for entrepreneurs just the same. When an entrepreneur begins a new venture, the entrepreneur will face more than just financial obstacles, ethical dilemmas will stand in their way. No one wants to act unethically, and no one starts a new dream with the hopes of cutting corners. Hisrich et al. (2017) point out that when reflecting on why an entrepreneur started the business in the first place, it can be a useful step to avoid ethical dilemmas. Some of the ethical breaches of entrepreneurs are using business funds for personal use, keeping cash payments off the books, cheating customers out of quality, delivery, and other aspects, as well as using deceptive advertising (Hisrich et al., 2017). Though it might be easier to sell a product that has a manufacturing flaw rather than re-manufacture, it is crucial for an entrepreneur to deliver the highest quality product to their customers. Some other ethical issues an entrepreneur faces are who owns the idea, how will the idea be funded, and when is the right time to work on the idea? All entrepreneurs want to create something that they can be proud of and something that reflects positively on them, so the entrepreneur must monitor their every action and ask themselves if what they are doing is something they can be proud of.

    For example, an entrepreneur gets a great idea for a new product while working in a group at their current job. The collaborative team meeting sparks a new idea in the mind of the entrepreneur that she believes will do great on the market. The idea was suggested for the current company, but the company decided they were not going to pursue it. She is worried that since the idea stemmed from the team meeting, it may not be seen as solely her idea. The entrepreneur is open to creating a team for her new venture, so after much deliberation, she speaks with her coworkers that were a part of the team meeting. She explains the idea and her plan to move forward with the idea in an entrepreneurial way and offers to any of the team members if they would like to join her and if they are comfortable with her using the idea. All the members of the team meeting are comfortable with the entrepreneur using the idea as solely her own. Do you think this was the ethical way for the entrepreneur to handle the situation? I look forward to your feedback!

Peer# 3

Hi everyone!

           Phelps Memorial Hospital Center is a community hospital of 235 beds that operates at 70 percent occupancy (Kovner & McAlearney, 2013). The region that the hospital operates in is overbedded and Phelps must collaborate and compete with the multitude of other facilities in the area. In 2010, Phelps and its medical staff were facing financial problems caused by many differing factors. One of these was Medicaid and Medicare payments that the hospital was receiving. It was pointed out that the reimbursement rates Phelps was receiving were a rate lower than cost, which contributed to the estimated decrease of $3.5 million per year (Kovner & McAlearney, 2013). This decrease also caused Phelps to toy with the idea of discounting some outpatient services, which would decrease patient volume each year. Kovner and McAlearney point out that there was a 10.3% increase in healthcare costs for the facility between the years 2007 and 2009. Another reason Phelps was facing financial problems was that physicians wanted compensation for being on call, treating Medicaid patients, and for the referral of patients (Kovner & McAlearney, 2013). To counteract these issues, a physician recommends that Phelps partner with a teaching hospital. Teaching hospitals bring together medical education, research, and patient care in a unique environment where the next generation of doctors, nurses, and other health professionals are trained (AAMC, n.d.). Partnering with a teaching hospital can make the facility seem more appealing and offer a great incentive for physicians to practice there. Another option to counteract the financial issues at the facility is to improve patient care and quality. Medicare and Medicaid reimbursements are often based on the quality of care, not the quantity of care, so it is important for Phelps to provide the best possible care to receive the best possible reimbursement.

           As a young physician, I would expect the hospital to be operating at its best possible level. A young physician just spent years in medical school, facing a multitude of obstacles to get where they are now. A hospital needs to recognize that young physicians want to be recognized and rewarded for their hard work and dedication. The hospital, on the other hand, should expect all their doctors and nurses to be providing the best possible care and hold everyone to the same standard. The lives of others are in the hands of physicians and hospitals need to expect that all doctors are performing at their best. It is crucial for facilities to recognize the effort physicians put forward and understand that burnout is a real thing. Though patient care is a top priority, so should self-care be. Do you think it is a fair expectation to set that all physicians should be performing at their best and should be recognized for their hard work? There needs to be a balance and understanding of the expectations between both the physician and a hospital, because, without one, the facility will face problems, just like the ones in this case.

I look forward to your feedback!

Peer# 4

Phelps is a community hospital of 235 beds, operating at 70 percent occupancy. Their services include medicine, surgery, psychiatry, obstetrics, pediatrics, and physical rehabilitation (Kovner & McAlearney, 2013). Some of the financial problems including recent healthcare reforms have negatively impacted the hospital profits, doctors are not getting paid an acceptable wage and are often not paid to make ER visits, and some of the older doctors do not possess updated healthcare education and training. 

Dr  Seebacker recommends that the hospital get rid of subpar doctors. This would reduce costs and free up funds to make improvements in staff and potentially help find ways to improve production. Dr Fass thinks that patients should only be admitted if necessary. This would reduce costs and free up space for other patients. He also thinks the hospital should be a teaching hospital. This would attract younger doctors and improve patient care. This could reduce costs because younger doctors are paid less than older doctors generally. Dr Peress thinks that the hospital should focus on hiring specialist providers. This would cost more, but it would draw more patients to the hospital, which would increase production. Dr Faltz believes the use of healthcare reform negatively impacts provider pay and treatment. Improving provider pay can result in happier providers that are willing to work hard to improve the hospital performance and improve production. 

I believe the CEO should proceed by implementing training into the hospital, which will improve patient care and draw in more providers. I also think the providers should be compensated for ER visits since the hospital does make money off of those visits. The older providers should be required to either step down or obtain the latest educational information. This is important to provide the best patient care and to ensure the doctors are all working to stay productive in the workplace. It also helps reduce complacency. The risks include a loss of older providers, but the potential gain is younger, more eager providers that are willing to put in the work. As mentioned in the text, providers over 55 years old are not even required to take calls (Kovner & McAlearney, 2013). This is not good teamwork and needs to be addressed. Younger providers are usually more willing to do the tasks that veteran providers are not willing to do, such as take calls. 

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