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Essay: 5 challenges healthcare leaders face & how they can be addressed through leadership skills

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Final Project

12-14-2018

Please discuss five challenges healthcare leaders are facing today and how they are and can be addressed through Leadership skills?

According to research completed by ACHE there are top 10 issues that healthcare executives are facing today are as follows. In which I will be discussing in depth about five challenges.  I will also be explaining their solution through leadership skills.

Physician hospital relations

Physicians and hospitals must familiarly cooperate or care does not get delivered as expected. At the same time, hospitals and physicians directly compete in various fields like surgery, imaging, and other different ambulatory services. In this relationship of synchronized competition and interdependency, the borderline between hospitals and physicians is filled both with economic conflict and legal risk. I believe in conflict with physicians over contracts, practice prerogatives, and scope of professional practice poses one of the single most career threats to hospital administrators will be facing.

Personnel shortages

One of the challenges in healthcare is human resource issues involves recruiting. Yes here are a few reasons causative to this problem. Firstly the baby boomer generations continue to age, their huge numbers create a considerable workload for medical professionals. It’s affecting the problematic from the inside as well; as nurses from that baby boomers generation are beginning to retire and leave the workforce thus there is personnel shortage. Another reason is approach to keep up the employees, some healthcare intuitions are already doing this by offering various technical and leadership training, development and different competitive benefits packages, including tuition reimbursement, paid holidays and other attractive benefits to create attraction with their current employees. There are institution were employees are stole to other organization as well.

Access to care

As many as 57 million Americans currently live in a rural area, according to the American Hospital Association. These individuals face a series of challenges, ranging from where they reside to having enough specialist doctors and physician  to provide healthcare. The patient-to-primary care physician ratio in rural areas is 39.8 physicians per 100,000 people, compared to 53.3 physicians per 100,000 in urban areas, according to statistics from the National Rural Health Association. Healthcare organizations need to have the right patient centered mechanisms in place that ensure each and every patients can easily access those care services which is one of the problem faced by current physicians and leaders of healthcare.

Reorganization

Major organizational changes among hospitals, like pro system connection, merger, and closure, they would seem to offer extensive opportunities for hospitals and health systems to be more strategic in the local reconfiguration of healthcare provided services. These Mergers often served to adapt various critical, inpatient capacity to other functions, with more acquired  to hospitals continuing critical services after merger. In the context of health care reform, mergers may offer a immediate way locally to restructure health services and challenges to leaders, physician and healthcare mangers. Various evidence on the post merger uses of hospitals system and about the purposes given for merger suggests that mergers may also reflects mainly on two different strategies.

Patient Satisfaction

Patients plays unique role in healthcare in which their satisfaction plays massive important role. Patient satisfaction is an extremely desired outcome of a clinical care in the hospital and may even be an element of health itself that determine quality of the healthcare provides. A patient’s different expression of satisfaction or dissatisfaction is a judgment on the quality of hospital care in all of its various aspects; this might effect the patient recommendation. Whatever its strengths and service limitations, patient satisfaction received by patient in certain healthcare is a pointer that managers should be crucial to the their service assessment of the quality of care in provided by hospitals that leads to patient satisfaction. For healthcare managers Patient satisfaction is the health care receiver reaction to aspects of his or her service experience. The reviews and ratings for the clinic will hamper the healthcare facility despite of their Excellency. I will mention this in depth on MACRA and Medicaid below.

Now I will explain in brief about the top five challenges healthcare leaders are facing today.

Financial Challenges

Healthcare is all about finance and money. US spends over 18% of the GDP in Healthcare. Healthcare finance includes the various mobilizations of funds for health care, the distribution of healthcare funds to certain sections and demanded population groups and for specific types of health care(including long term and short term care), or techniques  for paying for health care including pay for visit and those covered by insurance. Rising health care costs continue to dominate the American health policy forms and  agenda with growing expense in healthcare. This is growing over the year. Accordingly, there are thousands of different publications, hundreds of healthcare professional and support organizations, and  well-funded presentation on how budget will be used and allocated  about presented health finances. In the situation of this activity, the National Conference of State Legislatures (NCSL) has concentrated its own resources on questions frequently asked by different state legislators and lawmakers. With growing expense on healthcare this one of the challenges that is very common for healthcare managers are facing today. Using those finances properly is another challenges on the way.

Hospitals and health systems are under constant pressure to reduce costs while also improving their service quality and maintaining a bonded strong workforce. With this challenges comes an assortment of financial challenges, as reimbursement levels continue to change, grow and healthcare becomes more consumer-centric and challenges to the physician.

Some of the ways managers use to tackle the financial challenges are

  • Way of recruiting and retaining their current physicians

  • Way of riving revenue growth and its competition

  • Way of increasing Revenue cycle collection and reducing it on low bad debt.

  • Employee engagement in order to maintain quality to respect to financial challenges and its proper utilization.

    ACHE survey revealed that among the most concerning financial issues are the huge Medicaid reimbursement (this includes adequacy and timeliness of payment since Medicare takes longer duration to recover and collected), this result increasing costs for staff, supplies and time. While reducing operating costs at same time, and the transition from changes practices volume to value after the execution of the Medicare Access and CHIP Reauthorization Act (MACRA). First disbursement starts from January 1 of 2019. Healthcare does not runs on money whereas as a healthcare leaders their challenged are utilization it at the finest way to keep organization efficient and running.

    Governmental Mandates

    Centers for Medicare & Medicaid Services (CMS) regulation, regulatory/legislative uncertainty Affecting strategic planning, cost of demonstrating healthcare compliance, and state and local regulations/mandates are among the most concerning issues leaders are facing. This is mentioned at the ACHE survey as well.

    With changing rules and regulation, managers need to keep up to with the policies and changing regulation. Keeping an update with the policies will lift up organizational welfare and updated. At the same time employees needs to be updated and mentioned about the ongoing rules and regulations as well. For leaders government mandates are the direct policy of healthcare. In which they are under law to execute it to stay out of trouble. Staying out of law in serious consequences.  

    The government increased demand also known as mandates with the course of Medicare and Medicaid while restricting the supply of care providers and hospital organization. Health care prices responded as much as twice the rate of increase. Currently, the Government mandates are repeating the same mistakes with the debut of Affordable care act also known as Obamacare. Currently Trumpcare is in policy. Trumpcare is a nickname for the American Health Care Act (AHCA), a replacement plan for the Affordable Care Act (ACA or Obamacare) that was written by Republicans in the House of Representatives and passed. The AHCA was voted on, and passed in the House of Representatives on May 4, 2017. Yes, manager needs to keep up with the current government policy. Policies cannot remain static in today’s health care regulatory environment, yet revising them too frequently may actually increase noncompliance due to information overload, more information could cause overload on leaders. With modern technology there can be choice of mentioned policy and procedures for healthcare managers and leaders.

    Patient Safety and Quality

    Quality improvement is defined “as systematic, data-guided activities designed to bring about immediate improvement in todays health care delivery in particular healthcare delivery settings” A quality improvement strategy is defined as “any intervention aimed at reducing the quality gap for a group of patients between representative of those confronted in routine healthcare practice received by consumers”.

    Patient safety is one of the most important elements of healthcare system. Strong health safety and care teams reduce infection rates that might be inbreak within an organization, putting way of payment in place to avoid simple mistakes, and ensure strong appearances of communication between hospital staff, patients, and family members, the chain of communication is the key to reduce the errors. This will lead to repeated care and cost to hospital. Thus money and care will be spent more on same task.  Patient safety is an important component of a successful healthcare system; efficient health care system where quality overcomes with less errors and patient received excellent care. Leaders are always looking over Safety and Quality.

    Population Health Management

    We blame so much to our healthcare system in fact most of our healthcare is dependent upon individual behavior (40%) and genetics (30%).  Healthcare only controls 10% of the total health of a person. In fact they are being blaming healthcare system.

    Healthcare system investing in public awareness program will sort this kind of problem. For example, a child discharged from children’s hospital keep coming back for same reason until the doctors found that child was being underfeed, malnutrition. The environment in which the child was living was very poor. This example states that good education and good environment wouldn’t bring that child back and back again. Managers must be aware of investing in public health management. A budget on this kind of program will save hospital time and cost to solve same problem. Education, and a healthy lifestyle will reduce the uneccesary healthcare requirements. Vaccination programs, public education awareness are gem in this practice. Leaders are confident that proper awareness will reduce people demand in multiple care on same conditions. Managers and leaders must always be ready to adopt this practice to enlighten their skills.

    Technology

    Technology is a huge deal in healthcare. Healthcare is changing day by day. With new technologies coming each and everyday. Transformation is required to keep up with the modern technologies.  Technological improvements in healthcare have saved countless lives and improved the quality of todays life for even more further. Technology changed experiences for patients and their families, but it’s also had a huge influence on medical processes and the practices of healthcare professionals. Nowadays we can use our personal device to talk to a doctor and take suggestion. We can get our prescription delivered. Consumers are looking to adopt those technologies. Managers need to keep up with technology. The use of HER has transformed healthcare. From beginning primary care providers are now responsible for inputting patient data such as vital signs, proper body weight, height, lab test result into a common hub central server, EHR digitized system. On the healthcare managerial administration side of things, medical billers and coders use EHRs for scheduling various appointments, updating patient records with medical diagnostic codes, and receiving medical claims to be taken action of.

    MACRA

    The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is a bipartisan legislation signed into law on April 16, 2015. It establishes new ways to pay physicians for caring for huge number of Medicare beneficiaries. Physicians will increasingly be paid based on the outcomes of their care provided insuring their efficiency. To pay for their value, it must be defined indicators or measures of good care will be selected to evaluate their performance. These measures, once selected, will be used to determine increasing percentages of Medicare payment. Thus based on their performance payment will be released topping over their original payment.

    The law also includes

  • New funding for technical assistance to healthcare providers

  • Funding for various means and measure of development and testing.

  • It enables new programs and requirements for EHR data sharing, and establishes new federal advisory groups to monitor.

  • It is comprehensive legislation that has the potential to significantly restructure US healthcare, it is also quality based outcome to existing healthcare service provided.

    Alternative Payment Models (APMs)

    This model provides a new way for Medicare to compensate healthcare providers for the care they give to most care providers and Medicare beneficiaries. Most providers who participates in APMs will also be subjected to MIPS, but will receive favorable scoring with correspondingly higher reimbursement rates based on performance. Providers participating in the most advanced APMs (also including Accountable Care Organizations (ACOs), Patient Centered Medical Homes and Bundled Payment Models) may be designated as Qualifying APM Participants (QPs), which are not subject to MIPS.

    They may be eligible for:

    a.     Annual 5% lump sum bonus added payments to their original from 2019 through 2024;

    b.     Beginning in 2026, thus the higher annual premiums for the number of participating care providers.

    c.    After achieving this threshold, excluded from the MIPS reporting requirements and payment through adjustment.

    Work Cited

    Sobel DS. Rethinking medicine: improving health outcomes with cost-effective psychosocial interventions. Psychosom Med. 1995;57:234-44.

    Hughes, Ronda G. “Tools and Strategies for Quality Improvement and Patient Safety.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, www.ncbi.nlm.nih.gov/books/NBK2682/.

    Centers for Medicare & Medicaid Services.(2018).  “Quality Measures Requirements.” Alternative Payment Models (APMs) Overview – QPP, qpp.cms.gov/mips/quality-measures.

    Clough JD, McClellan M. Implementing MACRA Implications for Physicians and for Physician Leadership. JAMA. 2016;315(22):2397–2398. doi:10.1001/jama.2016.7041

    Hirsch, J., Rosenkrantz, A., Ansari, S., Manchikanti, L., & Nicola, G. (2016). MACRA 2.0: Are you ready for MIPS? Journal of NeuroInterventional Surgery, 9(7), 714-716.

    Hussey, P., Liu, J., & White, C. (2017). The Medicare Access And CHIP Reauthorization Act: Effects On Medicare Payment Policy And Spending. Health Affairs (Project Hope), 36(4), 697-705.

    Aaron Young, Humayun J. Chaudhry, Xiaomei Pei, Katie Arnhart, Michael Dugan, and Gregory B. Snyder (2017) A Census of Actively Licensed Physicians in the United States, 2016. Journal of Medical Regulation: June 2017, Vol. 103, No. 2, pp. 7-21.

    Cutler, David M. “What Is The US Health Spending Problem?” Health Affairs, vol. 37, no. 3, 2018, pp. 493–497., doi:10.1377/hlthaff.2017.1626.

    Centers for Medicare & Medicaid Services.(2018).  “Quality Measures Requirements.” Alternative Payment Models (APMs) Overview – QPP, qpp.cms.gov/mips/quality-measures.

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