Journal of Health Care Finance最新文献

The primary purpose of this article is to evaluate a proposal for a regional hospital to create a second Pulmonary Function Test laboratory (PFT lab) for outpatients. We separated the PFT lab from its departmental budget, thereby allowing a unique determination of the lab's profitability. The lab's separate financial analysis helped us to gain an understanding of the revenues and expenses of the PFT lab, providing information needed to comment on the proposed second lab. Additionally, we recommend a means for maintaining separate control over the PFT lab's revenues and costs and ascertain the efficacy of instituting a separate budget for the PFT lab.

This article analyzes the concept of intellectual capital (IC) in the health sector sphere by studying the case of a major nonprofit research organization in this sector, which has for some time been publishing IC reports. In the last few years, health care organizations have been the object of great attention in the implementation and transfer of managerial models and tools; however, there is still a lack of attention paid to the strategic management of IC as a fundamental resource for supporting and enhancing performance improvement dynamics. The main aim of this article is to examine the IC reporting model used by the Center of Molecular Medicine (CMM), a Swedish health organization which is an outstanding benchmark in reporting its IC. We also consider the specifics of IC reporting for health organizations, the lessons learned by analyzing CMM's IC reporting, and future perspectives for research.

The United States, Germany, and the United Kingdom are experiencing a trend toward the privatization of hospitals--most frequently involving poorly positioned facilities that need: additional capital for replacement of plant and equipment; improved management systems to reduce the number of their nondirect patient care employees; and an aggressive physician recruitment effort. A number of these institutions might have been otherwise shut down, resulting in the loss of good paying jobs; however, these closures would have reduced the nation's total health care expenditures. The acquisition in the United States and Germany by investor-owned hospital corporations of major teaching institutions suggests that the for-profits have become an integral part of their country's health care delivery system. Privatization now even occurs within the egalitarian British National Health Service with the availability of private medical insurance, private hospitals, and private beds in public hospitals being managed by investor-owned groups. Being acquired by a for-profit is often a means to secure needed capital and is politically less fractious than closing down a marginally needed government-sponsored or a not-for-profit facility.

Objective: Following efforts made in recent years to have effective mental health treatments based on evidence-based guidelines, a working-definition of a minimum level of 'adequate mental health care (AMHC)' for serious mental illness (SMI) was developed in the literature. However, little is known about racial/ethnic disparities in receipt of adequate mental health care for SMI. The objective of this study was to examine disparities among Whites and non-Whites in receiving adequate mental health care for past-year major depressive episodes (MDE).

Methods: The study sample was 1,688 US youth 12 to 17 years old affected by MDE in the 2005 National Survey on Drug Use and Health. We estimated the percentages of Whites and non-Whites that received adequate mental health care for MDE and estimated the correlates of receipt of adequate mental health care for the full sample and by racial/ethnic groups.

Results: About 34 percent of the sample received adequate mental health care; but separate analyses indicate that a significantly higher proportion of Whites (36 percent) received adequate mental health care relative to non-Whites (28 percent). The odds of receiving adequate mental health care for past-year MDE for Whites were 1.5 times that of non-Whites (p = 0.01).

Conclusion: As more adolescents of diverse racial/ethnic backgrounds are identified to access mental health Treatment services, it might be important to examine the degree to which treatment should be tailored to engage and retain specific racial/ethnic groups to get the minimum of adequate mental health care.

Pharmaceutical firms can apply for the Food and Drug Administration to 'fast track' research and de velopment on new drugs, accelerating clinical trials and expediting regulatory review required prior to marketing to consumers. We investigate security market reaction to more than 100 fast track designations from 1998 to 2004. Fast track designation appears to enhance investor recognition of firm value. Specifically, fast track designation coincides with abnormal trading volume and excess daily stock returns for sponsoring firms. Institutional ownership and analyst attention also increase. Market response is more pronounced for firms that are smaller, do not yet market products, and have low institutional ownership.

Data envelopment analysis (DEA) techniques have been applied to the assessing efficiency and productivity among individual hospitals. In this article, we employ DEA to address whether economies of scale exist among hospital markets by first assessing individual hospitals operating in 2005 in the State of Florida and then by comparing hospital markets' efficiency relative to each other. The interest in hospital markets stems from issues relating to mergers among hospitals or the reallocation of services (inputs) among hospitals in a market area, particularly as occupancy rates and reimbursements are tending to fall. Facing more competition and stringent financial conditions, hospitals would benefit from decreasing costs by exploiting economies of scale.

The antidote for a healthy bottom line is a streamlined payment recovery process from self-pay patients. Due to the current high unemployment rate and a resulting spike in self-pay patients, CFOs must be proactive and identify self-pay debt recovery solutions to stay in the black. It is vital to design an effective and efficient process that works for the specific needs of the hospital or practice. Utilizing metrics, reconditioning patients to pay at point-of-service, training associates to appropriately request payment, and understanding the limitations of the business office are key elements to financial health. Identifying an accounts receivable management partner could significantly reduce headaches and strain on staff and time.

The American Recovery and Reinvestment Act of 2009, often called the Stimulus Package or the Stimulus Bill, contains a section called the Health Information Technology for Economic and Clinical Health Act (HITECH Act). The HITECH Act made several significant changes to the current HIPAA Security and Privacy Rules and provided funds and incentives to increase the use of electronic health records (EHRs) by eligible physicians and eligible hospitals, as discussed below. The HITECH Act also provides funding for the Office of the National Coordinator for Health Information Technology, which oversees technology standards, implementation strategies, and impact assessment. The goals of the Office of National Coordinator are to achieve use of an EHR for each person in the country by 2014 and to develop a nationwide health information technology infrastructure in support of the first goal. Further, the HITECH Act provides funding for establishing at least 70 regional centers to help promote the adoption of EHRs. These centers are to offer technical assistance, guidance, and information on best practices to help providers achieve meaningful use of EHRs. This article will define the EHR, discuss the HITECH Act EHR stimulus, and explain the problem with the HITECH Act EHR incentive time-frame.

This article examines demand factors for sophisticated medical treatments offered by private hospitals operating in India. Three types of medical tourism exist: Outbound, Inbound, and Intrabound. Increased profitability and positive growth trends by private hospital chains can be attributed to rising domestic income levels within India. Not all of the chains examined were financially solvent. Some of the hospital groups in this sample that advertised directly to potential Inbound medical tourists appear to be experiencing negative cash flows.

States are experimenting with different forms of delivery and financing to make Medicaid expenditures more predictable. Florida Medicaid is experimenting with a relatively new form of managed care, the provider-sponsored organization (PSO). Using the Donabedian structure-process-outcome (SPO) model, patient experiences and utilization in Florida PSOs and primary care case management (PCCM) were compared. The study analyzed Consumer Assessments of Healthcare Providers and Systems (CAHPS) data for 1,257 Medicaid beneficiaries in Florida in 2005. Results showed that beneficiaries in the PSOs had similar ratings and reports of care to those in the PCCM. However, PSOs had lower physician visits compared to the PCCM, indicating potential access barriers to primary care. The PSO's impact on emergency department (ED) utilization and specialist utilization was similar to that of the PCCM. The PSOs may lower costs, but the savings may be due to lower physician utilization rather than better case management. This is important since states that are experimenting with PSOs in their Medicaid programs are looking to these organizations to improve beneficiary care while lowering costs.