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Principles of Healthcare Management. HCM-401 Kemal Erkan, FACHE. HCM-401 Week I. Syllabus Overview Group Project Case Study Midterm and Final Pre-test Group Project Outline Kyle Bain EMR Incentive Presentation Meaningful Use Core Measure Week I presentation by Kemal Erkan.

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Presentation Transcript
slide1
Principles of Healthcare Management

HCM-401

Kemal Erkan, FACHE

hcm 401 week i
HCM-401 Week I
  • Syllabus Overview
      • Group Project
      • Case Study
      • Midterm and Final
  • Pre-test
  • Group Project Outline
  • Kyle Bain
      • EMR Incentive Presentation
      • Meaningful Use Core Measure
  • Week I presentation by Kemal Erkan

Changing the Behavior

united medical community model
United Medical Community Model

PATIENT

ONE

Hospitals

CCHS

Bayhealth

AI DuPont

Beebe

CHART

  • Advanced Surgery
  • Cardiology
  • Dermatology
  • Family Practice
  • Gastroenterology
  • Hospitalists
  • Internal Medicine
  • Nephrology
  • OB/GYN
  • Ophthalmology
  • Optometrist
  • Pediatrics
  • Psychiatry
  • Physical Pain & Rehab
  • Podiatry
  • Pulmonary Disease
  • Radiology
  • Rheumatology
  • Sports Medicine
  • Urology

United Medical Network

DHIN

Labs

Other DHIN Organizations

  • Patient Demographics
  • Medication History
  • Allergies
  • Progress Notes
  • Flow Charts
  • Immunizations
  • All Other Patient Related Records

Changing the Behavior

united medical aco qualifications based on cms aco guidelines
United Medical ACO Qualifications based on CMS ACO Guidelines
  • ACOs must have a formal legal structure to receive and distribute shared savings to participating providers.
  • Each ACO must employ enough primary care professionals to treat their beneficiary population (minimum of 5,000 beneficiaries) as deemed sufficient by CMS.
  • Each ACO must agree to at least three years of participation in the program.
  • Each ACO will have to develop sufficient information about their participating health care professionals to support beneficiary assignment and for the determination of payments for shared savings.
  • ACOs will be expected to include a leadership and management structure that includes clinical and administrative systems.
  • Each ACO will be expected to have defined processes to promote evidence-based medicine, report on quality and cost measures, and coordinate care.
  • ACOs will also be required to produce reports demonstrating the adoption of patient-centered care.

Changing the Behavior

30 day readmission cost study
30 DAY READMISSION COST STUDY

Estimated # of Total Readmissions in 12 months 5,437

Average Length of stay (4 days: 5437*4) 21,748

# of Total Discharges 5,437

Total Encounters-Days 32,622

Average payment per encounter $ 80.00

Total Payment for professional Services $ 2,609,760.00

(=32,622*80.00)

Total Payment for Hospital Stay $ 150,789,758.00

(=5,437*27,734.00)

This Estimate study does not take the reduction on the initial admissions in consideration but only focuses on 30 day Readmissions.

Changing the Behavior

slide9
Organizational Structure

Board of Partners

Executive Committee (EC)

Doctors & Directors

Executive Director

Accounting

Operations

Legal

slide11
Old Method Of Reporting Sample

Changing the Behavior

balance sheet 2011
Balance Sheet 2011

Changing the Behavior

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