Introduction
Operation performance of the organization influences significantly the satisfaction of the patients and the financial progress of the hospital. Evaluations of the metrics that determine the operation performance in the healthcare are critical in determining the quality of the healthcare given by the hospital to the patients and the influence of the quality of the healthcare to the satisfaction of the sick and to the financial performance of the clinic. The leaders of the Healing hand hospital had realized value-based quality of healthcare was the key driving aspect in the healing industry. Determination of the performance of the clinic ion the lens of the quality healthcare provision was the key to determining the success of the hospital in both patient experience and satisfaction as well as in the financial perspectives.
The writer will evaluate the quality of healthcare metrics as the key determinants of the financial and satisfaction of the patients’ indicators and drivers. The author will use Healing Hands hospital for the case study. The author will evaluate the operation metrics such as length of stay in the hospital, rate of hospital acquired infections, and rate of re-admissions and their influence to the level of the quality of healthcare and patient satisfaction. The writer will evaluate the influence of the three operation performance metrics to the financial performance of the Healing Hands hospital. The paper will evaluate the influence of the three operation metrics to the hospital budget and reimbursement plan, especially the Medicare reimbursement design in the clinic. Finally, the paper will evaluate the influence of reimbursement and budget plan to the patient satisfaction and the quality of healthcare offered by the Healing Hands Hospital.
Operation Performance Metrics and Financial Trends at the Healing Hands Hospital
Healing hands hospital has been among the leading performing clinics in the region. The hospital is involved in providing healthcare for the largest of the community in the region. It offers a broad range of medical services that include dental, occupational, and infectious and community diseases, as well as other general diseases. The hospital offers medical care for the people that are not insured in the communities. To enroll in the hospital program, one must meet the minimum requirements that demonstrate the person may not be able to meet the insurance programs required by the Medicare and the Medicaid programs. The people that are insured or qualify to be insured by other insurance programs are referred elsewhere to the clinics that accept the forms of the insurance. The clinic can be said to be one of its kind in the region. Due to the nature and the financial status of the patients attended in the hospital, the length of stay, rate of re-admission, and the hospital acquired infections lay a critical role in determining the satisfaction of the patients and the quality of healthcare given by the clinic (Healinghandshealthcenter.org, 2017).
The clinic has above the national average stay on the hospital. The stay in the hospital described in this case includes the unnecessary inpatient programs promoted by the clinics to boost their financial performance. Although the hospitals are tasked and believed to be the promoters of health and wellbeing of the people, they are sometimes involved in malpractice where the hospital management and authorities may extend unnecessarily the inpatient plan of the patients thereby increasing the amount spent by the sick in the hospital. In addition, it was discovered that hospitals administered unnecessary treatment and tests to increase the value of the patients in the clinics (Cdc.gov, 2017).
The realization led to the strict interference of the operations of the hospital by the healthcare insurance providers that paid for the amount spent by the patients in the hospitals. Comparing the performance of the Healing Hands hospital and other clinics in the region in the lens of the length of stay in the hospital, the business has significantly decreased length of stay. The decreased length of stay can be attributed to the nature of the patients that they treat. The patients treated in the hospital are people that are not insured. Therefore, increasing their length of stay unnecessarily would be a loss to the organization, lead to decreased quality if healthcare provided by the organization, as well as reduce the number of the patient that can be served by the organization (Kandilov, Coomer & Dalton, 2014).
The rate of readmissions to the hospital could be employed to determine the operation performance of the organization and the quality of the healthcare provided by the clinic. The rate of re-admissions in the Healing Hands hospital is below the average for the nation and the State level. Comparing the business with other clinics in the region that offers general healthcare to the people in the region, the hospital has lower re-admissions. Lower re-admissions can be used to indicate improved quality of healthcare and operation standards in the hospital (Cdc.gov, 2017, p. 3).
The hospital rate of acquired infection is lower than the national and the State levels. The data collected from the patients’ feedback and from the State statistics indicate that clinic has lower number of acquired hospital infections as compared to the other organizations providing similar services to the people. Although the hospital provides different treatment services for broad community, family, and personal diseases, the clinic has managed to reduce significantly the rate of hospital acquired infections through categorization and separation of the patients according to the condition manifested. The design has led to improved satisfaction of the patients in the hospital and the perceived improved quality of healthcare provided. The average stay in the hospital affects the clinic budget and reimbursement. The budget of the hospital and the reimbursement design influences the value and quality of the treatment offered by the clinic significantly (Kandilov, Coomer & Dalton, 2014, p. 69).
The length of stay on the hospital influences the amount spent by the patients in the clinic. For the organizations that are genuine and strive on improving the value and quality f the healthcare provided to their patients, they ensure their patients do not stay more than necessary in the clinic. Other organizations extend the stay of their patients unnecessary that translate to increased expenditure by the patients in the hospitals. Increased stay influences the quality and value of the healthcare provided negatively since the patients spend more than necessary and spend more time in the hospitalized environment that is not so appealing to many people.
The healthcare insurance providers and the centers for the treatment and care have determined that organizations have embarked on increasing the stay of the patients to increase their revenues and profits. Other designs that have been employed by the clinics are irrelevant tests and treatment aimed to increase the amount spent by the sick in the hospitals. Evaluation of the quality of the healthcare provided by the patients has established that the length of stay is one of the critical factors that can be used to determine the performance of the hospital. In addition, the length of the stay of the patients was determined to influence significantly the financial performance of the clinics (DeWalt, Oberlander, Carey & Roper, 2005).
The length of stay in the hospital influences the financial performance of the organization. For the Healing Hands hospital that relies on donations and grants from well-wishers and the Government to operate, their decreased length of stay for the patients improves significantly their financial performance. The financial performance of the organization is not fostered by increased expenditures of the patients in the hospital as it applies to other clinics. On the contrary, improved financial performance of the clinic is fostered by reducing the amount spent on a patient without compromising on the value and the quality of the healthcare provided. On the other hand, the rate of re-admissions and hospital acquired infections are employed to determine the value and quality of healthcare provided by the clinics. The CMCs use the metrics to determine the operation performance of the hospitals and to rank them in terms of preferred healthcare providers in the PPO networks (DeWalt, Oberlander, Carey & Roper, 2005, p. 6).
The rate of re-admission will influence the budget of the patient and the reimbursement of the clinic now and in the future. With the increased evaluation of the amount spent by the sick in the hospitals in the reimbursement programs, clinics have been forced to embark on providing treatment for the lowest expenses possible. However, in their responding to the restrictions in the amount spent, they have sometimes embarked on decreased quality of healthcare offered to the sick. The decreased healthcare quality can be measured by the rate of re-admissions in the hospital. For the hospitals with increased rate of re-admissions, it is an indication that they offer low-quality treatment. The reimbursement of the amount spent by the re-admitted patients is considered as an extension and lack of appropriate health provision to the sick. The types of the re-admission cases have been categorized and each tagged with the corresponding reimbursement design and also influences the ranking of the clinic (cdc,gov, 2017, p. 7).
The rate of the hospital acquired infections is similarly used to determine the level of quality healthcare provided by the clinic. Medicaid and Medicare reimbursement plan is influenced by the hospital acquired infections. The reimbursement advanced by the insurance recognizes the primary conditions that were manifested by the patients at the time of admission. The conditions that develop later and are not related to the primary condition can be classified as the hospital acquired infections. The insurance programs cannot reimburse the clinics for the amount spent in treating conditions acquired in the hospitals. The considerations influence the budget of the hospitals significantly. On the other hand, Healing Hands cannot be affected by the reimbursement program since it treats people that do not have insurance plans (Cdc.gov, 2017, p. 8).
Conclusion
Evaluation of the operation performance of the organization is critical in determination of the quality and value of healthcare provided by the clinics. Length of the stay of the patients, rate of re-admissions, and hospital acquired infections influence the quality of treatment. The three metrics influence the budget and reimbursement design in the clinics. Overstaying of the patients in the hospital is used by the clinics to increase the amount spent by the patients in the hospitals. Insurance providers have identified unnecessary stay in the hospital as the source for unworthy revenues collected by the hospitals. Following that, the CMCs have grouped diseases and conditions that are similar and they reimburse similar amount irrespective of the time of stay and the type of treatment offered. Notwithstanding, the clinics are required not to compromise the quality of treatment to minimize their expenses. In such cases, re-admissions rate are used to determine low quality of administered healthcare that is considered in the reimbursement design. Healing Hands clinic cannot be influenced by these designs since it deals with the people that cannot afford and do not have any form of insurance coverage
References
Cdc.gov. (2017). FastStats - Access to Health Care. Retrieved from https://www.cdc.gov/nchs/fastats/access-to-health-care.htm
DeWalt, D. A., Oberlander, J., Carey, T. S., & Roper, W. L. (2005). Significance of Medicare
and Medicaid programs for the practice of medicine. Health Care Financing Review, 27(2), 79-90. Retrieved from http://web.b.ebscohost.com.proxy.cecybrary.com/ehost/detail/detail?sid=f856651b-5b2f-4925-b5c1-82e4e7bb7902%40sessionmgr107&vid=0&hid=123&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#AN=17290639&db=mnh
Healinghandshealthcenter.org (2017). About us. Avialble at:
https://healinghandshealthcenter.org/about-us/
Kandilov, A., Coomer, N., & Dalton, K. (2014). The Impact of Hospital-Acquired Conditions on Medicare Program Payments. Medicare & Medicaid Research Review, 4(4), E1-E23. doi:10.5600/mmrr.004.04.a01
