Principles of Healthcare Business and Financial Management

Healthcare Business and Financial Management Principles – Assignment Instructions

  1. Evaluate your organization’s current status with implementation of Value-based purchasing by doing the following:
    1. Discuss to what degree your organization has embraced Value-based purchasing
  2. Create a strategic plan to continue progressing VBP in your organization by doing the following:
    1. Identify three departments that will have the most impact on Value-based purchasing in your organization.
      1. Explain why the roles and functions of these three departments are important for implementing VBP in your organization.
    2. Discuss goals, for each of the three departments, that will help your organization further the implementation of VBP.
    3. Describe how each of the goals chosen in part 2.2 will help attain quality outcomes in both patient care and reimbursements over the next three years.
    4. Identify the key points for your strategic plan that are critical for the staff to understand and embrace.
      1. Discuss how you would market the key points of your plan to staff members.
    5. Reflect on how ethical clinical and ethical business practices will be incorporated into the strategic plan.
    6. Explain how to coordinate informational and educational events for the three departments identified in part 2.1.
    7. Develop a timeline to ensure that VBP is addressed over the next three years.
  3. Develop an executive summary as a separate document for key stakeholders and critical department leaders that includes the following:
    1. A description of the components of VBP that are most pertinent to the organization
    2. The preparation that the three departments chosen in part 2.1 will need for the implementation of VBP in the next three years
    3. A discussion of the education and training necessary to prepare the staff in the departments chosen in part 2.1 for implementation of VBP

Value-Based Purchasing Implementation – Principles of Healthcare Business and Financial Management Sample Paper

Value-based purchasing allows employers and insurers to measure and reward excellence in health care delivery. This is a demand side strategy that acts as a motivator for health care providers to improve their delivery systems by taking price, efficiency, and quality into consideration. The current organization has begun the process of embracing value-based purchasing as a step towards improving quality and patient safety. The Long-Term Care Setting is working extremely hard to align the physicians and the facility in delivering quality evidence-based care. The clinic is extensively involved with other clinicians in ensuring that it engages in measurable progress. Three years ago, the Long-Term Care setting established an initiative to provide efficient and quality care to all patients at all times. Additionally, the healthcare facility is developing a close working relationship with patient advocates to maximize health care quality and patient safety.

The three departments that will have the most impact on Value Based Pricing during its implementation are Finance Department, Quality Department, and Human Resources Department. Finance, Quality, and Human Resources department must work in collaboration to help the health care organization further the implementation of value based purchasing. Currently, these three departments rarely interact except when they want to discuss budget issues. The organization will effectively implement value based purchasing if financial matters, health care quality issues, and issues related to employee performance are aligned (Osborne and Reeves, 2010). Although every department has a separate role to play, it is anticipated that patients will best be served by bringing different ideas together to establish a strong financial-quality working relationship. When these departments work in collaboration, the health care setting will be able to provide financial quality reports, identify best practices that are related to quality, and design educational initiatives for employees to support its goal towards quality (Osborne and Reeves, 2010).

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The roles of Finance, Quality, and Human Resources Departments are very important for the implementation of value-based purchasing in the organization. The current health care challenge faced by the organization can be solved through two different approaches. The first approach is focused on improvement of employee health by ensuring that all determinants of health status are improved. According to National Business Coalition on Health (2011), organizations can enhance competitiveness, improve productivity, and lower health care costs by maintaining good health and preventing illness for all workers. Additionally, value based purchasing has the ability to change the manner in which employers offer health benefits to their workers in order to improve productivity. Effective implementation of value based purchasing therefore requires active response from Human Resources Department (National Business Coalition on Health, 2011).

The current organization is characterized by inefficiencies and wide variations in cost and quality. Furthermore, the organization largely focuses on treatment of illness with little focus on health improvement and management. The Quality Department will work very hard to ensure that heath care delivery in the organization is largely focused on health improvement and in assisting patients to receive the desired outcome (National Business Coalition on Health, 2011). Additionally, the reimbursement incentives currently used in the organization contribute greatly to the observed flaws in health care delivery. There is therefore great need for the current incentives to be changed as a way of making transformation in healthcare delivery system. It is the responsibility of the Finance Department to purchase the right incentives in order to ensure effective implementation of value based purchasing in the organization (National Business Coalition on Health, 2011).

The three departments-Finance, Quality, and Human Resources must have well defined goals that will help the organization further the implementation of value based purchasing. These goals will help the organization to attain quality outcome in both patient care and reimbursements over the next three years. Quality department should focus on achieving three different goals in its effort towards ensuring effective implementation of the value based purchasing. The first goal is to improve clinical quality in the entire organization. This goal guides Quality department towards ensuring that all clinical services offered to patients are of high quality at now and in three years to come (Deloitte Center for Health Solutions, 2011).

The second goal that the Quality Department should seek to fulfill is to encourage patient-centered care at all times in the organization (Deloitte Center for Health Solutions, 2011). Patient-centered care is an important part of evidence-based practice that is very crucial for implementation of value based purchasing. This goal will help the organization to attain quality in reimbursements over the next three years. The third goal related to quality that will help the organization further the implementation of value-based purchasing is to improve patient safety and reduce adverse events. Patient safety is a very good performance indicator that can be used to measure how care is delivered in a health care organization (National Business Coalition on Health, 2011). This third goal will assist the organization in ensuring that all its workers deliver care that is aimed at improving patient safety, and in the process attaining quality in patient care.

Similarly, the Finance department must strive to fulfill a number of goals in order to assist the healthcare setting in implementing value based purchasing. First, the Finance Department should aim at avoiding unnecessary costs in the delivery of care. Second, the department should aim at stimulating investments in all structural components of the organization and in engineering all processes that are used in the organization’s health care delivery system (National Business Coalition on Health, 2011). According to the National Business Coalition on Health (2011), effectively implemented value based purchasing is a good motivator for health care providers to lead reengineering in health care delivery. The Human resource department should focus on achieving three objectives namely; to avoid overuse, misuse, and underuse of services, to increase transparency in performance and make it useful to all patients, and to minimize current disparities and strive to avoid creating additional disparities (National Business Coalition on Health, 2011). By meeting these goals, the Human Resource Department will greatly help the organization further the implementation of value based purchasing. Consequently, the organization will be able to attain quality outcome in both patient care and reimbursements over the next three years.

Proper implementation of value-based purchasing depends on full participation of the staff. Therefore, members of staff are required to have a comprehensive understanding of the strategic plan for them to assist with implementation. The key points of the strategic plan that are critical for the staff to understand and embrace include; the gap that the organization needs to fill regarding implementation of value based purchasing, departments that will have the most impact on value based purchasing in the organization, the roles that these departments will play in implementation of value based purchasing, and the goals that will guide every department in assisting the organization further implementation of value based purchasing. In addition, members of staff should understand and embrace how each departmental goal will help the organization attain quality outcomes in both patient care and reimbursements over the next three years. Knowledge of these key points will guide members of staff on the specific tasks that they must perform to ensure that value based purchasing is effectively implemented in the organization (National Business Coalition on Health, 2011).

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Outlining the key points that staff members need to understand and embrace alone is not enough to bring about positive impact in the organization. These key points must be communicated to them in the right manner and at the right time. First, it is important to use discipline of a framework when marketing the key points to staff. When using discipline of a framework to communicate a strategy or a point, it is important to prioritize points based on their purpose (Everse, 2011). The leader should show staff members the main benefits of value based purchasing, explain to staff the strategic decisions of the organization, and communicate the connection between the new strategy and its purpose. Second, the leader should keep message simple and easy to understand. This will greatly influence the decision-making behaviors of staff and enable them to relate their efforts to goals of the organization. Third, the leader should use 21st century media to deliver the key points to staff. As Everse (2011), points out, the mechanism used to deliver a message is very important because it is as useful as the content itself. It is important to consider the roles of social media and other networking sites in passing out relevant information to users. The method of delivery chosen should be able to catch the attention of staff to a level that they did not expect (Everse, 2011).

Ethical clinical and ethical business practices must be incorporated in the strategic plan to make it more effective. For instance, the plan must have a standardized performance measurement system that helps to ensure that the needs of all people being served by value based purchasing are taken care of. It is important to measure performance first when using value-based purchasing to reward high quality health care in an organization. Performance measurement should be done in a similar manner across multiple organizational levels to avoid any form of discrimination. The plan should also measure consumer behavior, particularly the patients’ lifestyle choices. According to National Business Coalition on Health (2011), rewarding excellence without measuring performance is an extremely difficult task. This makes performance measurement a very critical factor in the implementation of value based purchasing. Inclusion of a standardized performance measurement system in the strategic plan is an ethical business practice (National Business Coalition on Health, 2011).

Additionally, the planner of the strategic plan must ensure transparency and public reporting in order to convert into something useful. Patients and members of staff should be able to access relevant information to facilitate their decision making process. According to National Business Coalition on Health (2011), performance can greatly be improved through regular and timely reporting. In addition, one of the special priorities for patient regarding implementation of value base purchasing is transparency in prices for health care services. Patients will only be in a position to make value-based decision if they are provided with quality and validated price information. The organization should therefore consider transparency factor as it tries to move its employees and the entire enterprise towards value based purchasing. One important factor that the health care organization must understand is the fact that what matters most to patients when it comes to implementation of value based purchasing is out-of-pocket costs, but not the overall health care cost. Transparency and public reporting is another example of ethical business practice (National Business Coalition on Health, 2011).

The organization must also pay attention to informed consumer choice as it continues refining the strategic plan. Informed consumer choice is an example of ethical clinical practice. Patients have a number of choices to make in their health care journey. These choices affect the cost and the quality of care they receive (National Business Coalition on Health, 2011). Examples of choices that may influence decisions made by patients include the degree of treatment compliance required, lifestyle, selection of the most appropriate health care provider, and the need to seek preventative care when they fall sick. A very critical element of value based purchasing is the fact that patients have individual choices which vary from one person to another. The desired goal of the patient will compel him or her to make health choices on the basis of value.  The organization must be ready to motivate health care consumers through incentive programs that will enable them to choose the right quality o care at all levels in the system (National Business Coalition on Health, 2011).

The three departments that will have the most impact in value based purchasing are situated at different locations in the organization, and there is great need of ensuring that there is constant flow of information from one department to another. In order to effectively coordinate informational and educational events for Finance, Quality, and Human Resources Department, the organization should create a central place where informational and educational events are conducted (Everse, 2011). This will required staff from all the three departments to converge in a central location to receive the necessary information. Staff can be informed about such a meeting using an internal memo. This form of coordination system works best when there is need for people from the three departments to work together. Otherwise, the organization can connect all computers in the three departments to a central one where all the necessary information is posted. In such a case, each of the three departments will be able to access relevant information in real time through their pre-installed computers (Everse, 2011).

In order to ensure that value based purchasing is implemented at the correct time, the organization needs to have a clear timeline that will guide the manner in which it conducts its operations. The organization should take three months in analyzing gaps that should be filled as far as implementation of value based purchasing is concerned. The next three months should be taken in reorganizing the Finance, Quality, and Human Resources in preparation for the implementation. The organization should focus on the actual implementation for one full year. In the final year, the organization should concentrate on system testing and monitoring. By doing all these, value based purchasing will have been addressed within a period of three years.

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