The effect of higher levels of medical spending, profitability, and fiscal margins on process quality for health care organizations

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The effect of higher levels of medical spending, profitability, and fiscal margins on process quality for health care organizations

The effect of higher levels of medical spending, profitability, and fiscal margins on process quality for health care organizations

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Describe the effect of higher levels of medical spending, profitability, and fiscal margins on process quality for health care organizations. Indicate the role of financial stability in health care organizations on their ability to adequately resource the staffing, equipment, and infrastructure that support care delivery. Specifically, what is the effect of financial flexibility in increased use of preventative and wellness measures and lower length of stay?


For this assignment, you are required to interview a senior executive of a health care organization. You must ask the following questions and also come up with two additional questions of your own in preparation for the Operations Analysis Diagram assignment:

  • 1) What type of health care organization are you affiliated with? What is your position within the health care organization? Describe your role and scope of responsibilities.
  • 2) Describe the relationship between your health care organization’s vision, mission, goals, and strategic
    The effect of higher levels of medical spending, profitability, and fiscal margins on process quality for health care organizations

    The effect of higher levels of medical spending, profitability, and fiscal margins on process quality for health care organizations


  • 3) Tell me about a time your organization’s operational performance affected, either positively or negatively, its ability to deliver services and achieve performance goals.
  • 4) Describe the process you take to deliver a particular type of service offered by your health care organization.
  • 5) Describe one aspect of your business operations. Submit a short reflection, 200-250 words, of your interview experience along with your interview questions and responses.

Your reflection should include the following:

  • 1) Your reaction to the interviewee’s response to each question. Were you surprised? Did you agree or disagree and why?
  • 2) Additional questions you have or information you would like to have had based upon the interviewee’s response.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Post your interview questions, including the two additional you developed, responses, and reflection to your instructor for this module and to the discussion forum under the appropriate thread in Module 4. the effect of higher levels of medical spending, profitability, and fiscal margins on process quality for health care organizations

HCA 610 Week 3 Discussion 2 Latest-GCU

Discuss Pettigrew’s theory on the contextual dependency of strategic change. Explain the concept of the disciplining context and why medical professionals accepted and used it. Also, explain why the internal market system, which was implemented to solve financial problems, was abandoned.the effect of higher levels of medical spending, profitability, and fiscal margins on process quality for health care organizations.

Similarly, quality and safety measures included in previous studies have been limited based on 1) use of distal outcomes such as mortality; 2) including only specific patient populations such as Medicare patients; and 3), including only select conditions, most commonly heart attack (AMI), congestive heart failure (CHF), and pneumonia (PN).[, , , , , ] These three conditions (AMI, CHF, PN) are among the most common causes of hospitalizations for the US population overall, particularly the elderly. There is scientific evidence supporting associations between mortality and readmission for these conditions with specific clinical care processes, leading to use of these indicators to measure provision of consistent quality of care for these conditions.[] These mortality and readmission indicators have been used as proxies for hospital quality in many prior research articles.[, , –]

Several quality and safety indicators are now publicly reported, including CMS Hospital Compare VBP Total Performance Score (VBP-TPS) and a Five-Star hospital rating system (). These measures, however, were designed for the specific purpose of payment reform and may not be ideal for research purposes. The VBP-TPS includes cost efficiency and year-by-year quality improvement, which may introduce confounding by past financial performance. Cefalu et al. recently reported use of principal component analysis across 25 hospital quality measures, concluding that four factors representing patient experience of care, select process of care measures, and inpatient mortality demonstrated the multidimensionality of hospital quality. []

Is hospital’s financial situation related to the quality and safety of the service it provides? 
While this seemingly simple and easy question has gotten lot of attention, it’s proven surprisingly tough to answer. 
Hospitals can accomplish more with less, according to efforts to decrease the excessive costs of health care in the United States. 
Hospitals are under lot of pressure to save expenses while maintaining high quality [1, 2]. 
Only if initiatives to financially reward quality, like as public reporting and value-based payment (VBP), are intended to account for the delicate relationship between quality and facility financial stability, will they succeed in improving population health for all. 
Otherwise, these schemes risk repeating the American health-care system’s “rich get richer” history, which will continue to penalize safety-net institutions and their underserved populations[3].


Prior research reveals that if hospital’s financial situation deteriorates, several areas of patient care may be jeopardized [4–11]. 
Direct studies exploring the relationship between financial position and the quality and safety of patient care, on the other hand, have produced mixed results. 
The lack of clear connections could be attributed to the weak predictive validity of financial and quality measurements. 
Many financial distress models focused on specific indications of stress, such as bankruptcy and closure data, which are easy to obtain but may not represent the full spectrum of financial health [12]. 
Other studies focused on only few aspects of hospital financial performance (e.g., operating margin), which do not account for the whole range of revenue that could be utilized to improve quality [13]. 
In terms of quality, studies have primarily focused on specific outcomes, such as mortality or hospital readmission due to illnesses including pneumonia, heart failure, or myocardial infarction [14–17]. 
The Centers for Medicare and Medicaid Services (CMS) expanded public reporting as part of VBP, expanding the pool of metrics accessible for quality review. 
(14, 18)


While most previous studies have taken limited approach to identifying the abstract measurements that indicate hospital financial health and quality of treatment, this research takes comprehensive look at financial features as well as patient quality and safety indicators. 
We believe that accurate monitoring of these financial, quality, and safety indicators will increase the chances of observing the link between poor financial health and poor hospital quality of care and patient safety. 
We wanted to see if composite financial indicator created from machine learning technology (principle component analysis) might beat previously established financial indicators in analyzing the relationship between patient care quality and safety. 
We give conceptual framework and the contribution of our analysis in the next part, which is followed by summary of numerous research that have assessed concerns related to the ones we are looking at. 
The description of study methodologies and metrics is then followed by presentation of the findings and policy implications.
Various financial indicators measuring profitability, liquidity, and solvency are significant markers of financial health when considering the financial health of hospital facilities; however, discerning financial health is complicated among hospitals, and it is difficult to rank the numerous indicators by importance or predictive power. 
Furthermore, individual indicators may not often capture all aspects of hospital’s financial health, and their value is uncertain because different studies name different metrics as the most effective predictors of imminent financial troubles. 
[19, 42–44] [19, 42–44] [19, 42–44] 
The use of financial data that focused exclusively on specific populations (e.g., Medicare patients), the outsized influence of institutions at the extremes of financial performance, and the use of gross metrics such as operating margin and total margin are all limitations of previous studies. 
Several studies have demonstrated that poor hospital financial health may contribute to higher unfavorable outcomes for some publicly reported outcomes but not others, using these limited techniques. 
The ambiguous results are difficult to understand because hospital margins can be deceptive indications of financial health, and negative margin or net loss aren’t the only markers of financial difficulty. 
For example, despite positive margins, some hospitals may not have enough liquid assets to meet all current and future quality improvement responsibilities. 
Nonoperating transfers, income from grants, debt forgiveness, and other omissions from standard accounting reporting may cause revenues to be understated. 
As result, it’s critical to analyze variety of financial factors, such as liquidity, financial leverage, and physical facilities. 
At state and federal agencies, more comprehensive financial data that better portrays hospital’s financial health is publicly published and available. 
This study demonstrates the importance of looking beyond the previously used narrow metrics of hospital financial health.
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