HSM 541 WEEK 6 YOU DECIDE RECOMMENDATIONS MEMO

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HSM 541 WEEK 6 YOU DECIDE RECOMMENDATIONS MEMO

HSM 541 Week 6 You Decide Recommendations Memo

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 hospital 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 health services

and neo-natal intensive care unit continue to lose money for the hospital.

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