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Organizational Leadership and Interprofessional Team Development C158 Western Governors University $10.49
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Organizational Leadership and Interprofessional Team Development C158 Western Governors University
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Organizational Leadership and Interprofessional Team Development C158 Western Governors University

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Document information

  • April 25, 2022
  • 17
  • 2021/2022
  • Exam (elaborations)
  • Questions & answers

Subjects

  • suppliers
  • organizational leadership and interprofessional team development c158 western governors university
  • healthcare is a business it has customers
  • government regulators and reviews on yelp hea

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  • LEADERSHIP C158
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Running head: LEADERSHIP C158 1




Organizational Leadership and Interprofessional Team Development



C158 Western Governors University



Organizational Leadership and Interprofessional Team Development




C158 Western Governors University

,LEADERSHIP C158 2


A.

Healthcare is a business. It has customers, suppliers, government regulators and reviews

on Yelp. Healthcare differs from many businesses in that customers, or patients, do not often

have a choice where the do business, or seek care. Insurance plans provide their members with a

list of providers they must see in order to be covered. Providers are held accountable no only to

the patient/customer but also to the regulators, some of whom are also those who pay the

customers bills.

The government, through Medicare and Medicaid, is in the position of making the rules

for the same people it does business with. It can tie compliance with its rules to reimbursement.

If a certain provider fails to meet a certain regulation, Medicare can limit or deny reimbursement

for that provider’s claim (Sullivan, 2013). An example of this can be seen in how reimbursement

is done for a certain procedure, Aortic Valve replacement surgery for example. By analyzing best

practices and outcomes over time, reimbursement agencies have decided on an average amount

and length of stay for this particular surgery. If a hospital can safely do the same surgery for less

or have a shorter length of stay, they can keep the remaining funds. If they spend more, or take

longer, the hospital makes up the difference. Financial motivation like this can help healthcare

facilities promote best practices and improve patient outcomes not just for improved patient-

centered care but for financial benefit as well.

While many ideas to improve patient safety are regulated by government agencies,

JCAHO calling for the use of computerized prescriber order entry for example, they are also

backed up by financial incentives (Sullivan, 2013). Research has shown that medical mistakes

are a frequent event in healthcare and the cost of these is now passed back to the facility.

Medicare and Medicaid have worked to make limiting mistakes a financial necessity for facilities

, LEADERSHIP C158 3


by not reimbursing costs tied to mistakes (Sullivan, 2013). By tying the regulation directly to the

reimbursement the facility is motivated to change its practices and eliminate mistakes.

Patient mistakes can be costly, due to lack of reimbursement or liability of the facility for

damages caused. An additional incentive for hospitals to improve care is by directly linking

reimbursement to “value and quality measures” including clinical outcomes and the patient

experience of care (CMS, 2018). The reimbursement rate for hospitals is directly tied to their

rating, and improvement over time, by patients regarding their experience of care. By following

the patient-centered care measures set forth by JCAHO (2014), and improving the patient

experience, hospitals can improve their reimbursement rate.

After a hospital stay, patients are sent a survey asking questions about communication

with doctors and staff, cleanliness, pain management and other measures of patient-centered

care. This Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)

survey is required by CMS for all hospitals and its results are made public as well as tied to

reimbursement (CMS, 2018). By directly surveying patients about their experience, and tying

reimbursement to it, patient-centered care has become directly connected to good business

practice as well as being required by regulation.

An example of this can be seen in the dissemination of information to patients. JCAHO

requires that hospitals “effectively communicate with patients when providing care” (JCAHO,

2014). Having access to a trained translator, or translation service, has become standard in many

hospitals. While this used to be necessary only for legal documents like consents, it is now

mandated by JCAHO that patients understand their care and have the opportunity to ask

questions in a language they understand. This requirement allows for better care, and better

understanding and satisfaction by patients and families, improving the sense of patient centered

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