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APA
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Health, Medicine, Nursing
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Case Study
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English (U.S.)
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Topic:

Improving the Financial Performance of Middlefield Hospital

Case Study Instructions:

Scenario Summary
You have been the Director of Operations for Middlefield Hospital for 2 and a half years and finally resolved the workforce challenges that plagued the hospital, and in particular the mental health unit. In a recent meeting, the chief financial officer (CFO) indicated that the financial performance of the hospital's mental health unit 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 neonatal intensive care unit continue to lose money for the hospital.
Your Role/Assignment
The board of directors has asked that you provide a 750-word report (double-spaced in APA format) detailing your strategies and recommendations to improve the financial performance of the hospital by focusing on the mental health unit. The strategies and recommendations should be as specific as possible and include identifying resources that are necessary to implement the strategies. Also, describe the outcomes expected from implementing your recommendations. Your primary text and journal and website research must be used as a reference to support your analysis. Use at least three references.
Available Resources
Review the points of view of the following people to obtain further insight on this assignment.
Key Players
Dr. McCrae: Psychiatrist
I am a psychiatrist and admit my patients to the mental health inpatient unit at Middlefield. It is the only psychiatric inpatient unit available in the community, and the care provided is excellent. I understand the program loses money, but the hospital has a community obligation to offer services to patients who need mental health care.
Aretha Holly: Pharmacy Technician
I love the health plan offered by Middlefield Hospital. The plan really meets the needs of my family. The copays and deductibles are so low and I get my prescriptions for free. Also, I can go to any provider I choose. I hope they don't make any changes to the plan, because I am worried that I may not be able to afford it.
Barbara Seville: Director of Quality Improvement
Middlefield's quality improvement activities are not effective anymore. We do lots of data collection and reporting, but there is little improvement in the quality of care. Most staff members believe that we already provide quality patient care and don't see why we are putting resources into this function. I think we are relying too much on our past reputation.

Case Study Sample Content Preview:

Improving the Financial Performance of Middlefield Hospital
Student Name
Institution
Course Name
Instructor
Date
Improving the Financial Performance of Middlefield Hospital
Middlefield Hospital’s Case
Middlefield Hospital is facing financial challenges. Opening a new institution in the neighborhood has contributed to the hospital's poor financial performance. The healthcare facility provides inpatient treatments; however, recently, fewer patients have been hospitalized. The service is not making revenue since its contracts with local businesses are over two years old, the ICU and mental health departments are experiencing losses, and the health insurance for staff members is too costly. It does not allow for deductions, and the recently opened hospital nearby has been promoting wellness in the neighborhood, drawing in younger households.
Strategies and Recommendations
The first recommendation is to reduce the cost of workers' health insurance. It is only feasible if the healthcare facility offers staff a payroll deduction plan and maintains them in a health coverage program. Their medical insurance should be considered and reduced by a minimal amount to avoid over-deducting employees with modest incomes from their health insurance. The institution should subsequently transfer these funds to an affordable medical insurance provider. The health insurance company should provide complete coverage for the workers, paying the company any costs associated with treating them at the same location or in a facility of their preference.
Another recommendation is to strengthen departments that are making losses. The facility knows the mental health and intensive care units are performing poorly, recording some losses. The company should urge each patient to acquire health insurance to reduce losses. Payments in cash should be discouraged, and patients should be helped to sign up with medical coverage service providers. Additionally, it can lower costs by allowing the institution to increase the price of acute care and mental health sections. The price will not impact patients but boost their appreciation of their health insurance plans (W Mayer, 2020). However, there should be supplementary reimbursement for higher-priced treatments that the two government-sponsored insurance schemes cannot cover. Medicaid and Medicare should also be promoted.
Additionally, it is recommended that the institution remain pertinent to local public health. The new facility should not cause the healthcare facility to lose customers. The group should make certain adjustments or changes that align with the needs of the contemporary neighborhood, such as establishing a cheap wellness facility. Additionally, the organization needs to consider its contract customers, like corporates and community groups, and work to extend existing agreements. The healthcare facility should be present in the community and use CSR techniques to help those who require medical attention (Beck, 2021). The facility needs to advertise its services, like those for psychological health. Certain services are not provided by any other healthcare facility in the neighborhood, including mental health services.
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