Principles of Healthcare business and financial Management- C162
INTRODUCTION
Current trends in healthcare, the recent recession and sluggish economic environment, and the passage of the Affordable Care Act have forced the U.S. healthcare system to develop better ways to provide effective care for less cost. Healthcare providers and facilities must demonstrate to the government, payers, and the public that they provide care that is high quality, safe, and at a reasonable cost. Becoming a healthcare provider of choice while closely managing the costs of doing business and ensuring appropriate financial reimbursements is the new reality for organizations and providers in the healthcare arena.
This assessment challenges you to demonstrate understanding of today’s complex healthcare environment while using the business and financial skills learned to develop a strategic plan to move your organization from the world of fee-for-service (FFS) to value based purchasing (VBP). You will evaluate your organization’s position and strategy for the implementation of VBP requirements. You will need to identify the key stakeholders that would be involved (e.g., board members, senior leadership team, physicians, directors, managers, staff, patients, and families). You will also need to identify the critical departments of your organization (e.g., nursing, clinical support departments, case management, supply chain, education, finance, decision support, risk management, revenue cycle, medical staff office, physician services, physician practices, community and public relations, marketing). Consider the various roles and functions for each department and stakeholder group and determine which roles should be included in a strategic plan that you will develop.
Your strategic plan will include elements to educate, communicate, mobilize, and monitor the tactics you wish to implement. You will identify the clinical and customer service components of VBP in the next three years and develop a strategy to identify, educate, and inform all stakeholders of the organization’s vision to achieve excellence in patient care and the highest reimbursements possible for the next three years.
REQUIREMENTS
Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. An originality report is provided when you submit your task that can be used as a guide.
Professional Communications is a required aspect to pass this task. Completion of a spell check and grammar check prior to submitting your final work is strongly recommended.
You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.
Note: Your submission may be in the format of a business plan document or a multimedia presentation. If a multimedia presentation is selected, speaker notes must be used to include the necessary level of detail and support. The executive summary in requirement C must be a separate document.
- Evaluate your organization’s current status with implementation of VBP by doing the following:
- Discuss to what degree your organization has embraced VBP.
- Create a strategic plan to continue progressing VBP in your organization by doing the following:
- Identify threedepartments that will have the most impact on VBP in your organization.
- Explain why the roles and functions of these three departments are important for implementing VBP in your organization.
- Discuss goals, for eachof the three departments, that will help your organization further the implementation of VBP.
- Describe how each of the goals chosen in part B2 will help attain quality outcomes in both patient care and reimbursements over the next three years.
- Identify the key points for your strategic plan that are critical for the staff to understand and embrace.
- Discuss how you would market the key points of your plan to staff members.
- Reflect on how ethical clinical and ethical business practices will be incorporated into the strategic plan.
- Explain how to coordinate informational and educational events for the three departments identified in part B1.
- Develop a timeline to ensure that VBP is addressed over the next three years.
- Develop an executive summary as a separate document for key stakeholders and critical department leaders that includes the following:
- A description of the components of VBP that are most pertinent to the organization
- The preparation that the three departments chosen in part B1 will need for the implementation of VBP in the next three years
- A discussion of the education and training necessary to prepare the staff in the departments chosen in part B1 for implementation of VBP
- When you use sources, include all in-text citations and references in APA format.
Note: When using sources to support ideas and elements in an assessment, the submission MUST include APA formatted in-text citations with a corresponding reference list for any direct quotes or paraphrasing. It is not necessary to list sources that were consulted if they have not been quoted or paraphrased in the text of the assessment.
Note: No more than a combined total of 30% of a submission can be directly quoted or closely paraphrased from outside sources, even if cited correctly. For tips on using APA style, please refer to the APA Handout web link included in the APA Guidelines section.
RUBRIC
ARTICULATION OF RESPONSE (CLARITY, ORGANIZATION, MECHANICS):
| UNSATISFACTORY/NOT PRESENT
The candidate provides unsatisfactory articulation of response. |
DOES NOT MEET STANDARD
The candidate provides weak articulation of response. |
MINIMALLY COMPETENT
The candidate provides limited articulation of response. |
COMPETENT
The candidate provides adequate articulation of response. |
HIGHLY COMPETENT
The candidate provides substantial articulation of response. |
A1:VBP DEGREE OF IMPLEMENTATION
| UNSATISFACTORY/NOT PRESENT
The candidate does not provide a logical discussion about the degree to which the candidate’s organization has embraced VBP. |
DOES NOT MEET STANDARD
The candidate provides a logical discussion, with no detail, about the degree to which the candidate’s organization has embraced VBP. |
MINIMALLY COMPETENT
The candidate provides a logical discussion, with limited detail, about the degree to which the candidate’s organization has embraced VBP. |
COMPETENT
The candidate provides a logical discussion, with adequate detail, about the degree to which the candidate’s organization has embraced VBP. |
HIGHLY COMPETENT
The candidate provides a logical discussion, with substantial detail, about the degree to which the candidate’s organization has embraced VBP. |
B1:DEPARTMENTS IMPACTING VBP
| UNSATISFACTORY/NOT PRESENT
The candidate does not identify 3 departments that will have the most impact on VBP in the organization. |
DOES NOT MEET STANDARD
Not applicable. |
MINIMALLY COMPETENT
Not applicable. |
COMPETENT
Not applicable. |
HIGHLY COMPETENT
The candidate identifies 3 departments that will have the most impact on VBP in the organization. |
B1A:EXPLANATION OF ROLES AND FUNCTIONS
| UNSATISFACTORY/NOT PRESENT
The candidate does not provide a logical explanation of why the roles and functions of these three departments are important for implementing VBP in the organization. |
DOES NOT MEET STANDARD
The candidate provides a logical explanation, with no support, of why the roles and functions of these three departments are important for implementing VBP in the organization. |
MINIMALLY COMPETENT
The candidate provides a logical explanation, with limited support, of why the roles and functions of these three departments are important for implementing VBP in the organization. |
COMPETENT
The candidate provides a logical explanation, with adequate support, of why the roles and functions of these three departments are important for implementing VBP in the organization. |
HIGHLY COMPETENT
The candidate provides a logical explanation, with substantial support, of why the roles and functions of these three departments are important for implementing VBP in the organization. |
B2:GOALS
| UNSATISFACTORY/NOT PRESENT
The candidate does not provide a logical discussion of goals, for each of the three departments, that would help the organization further the implementation of VBP. |
DOES NOT MEET STANDARD
The candidate provides a logical discussion, with no detail, of goals, for each of the three departments, that would help the organization further the implementation of VBP. |
MINIMALLY COMPETENT
The candidate provides a logical discussion, with limited detail, of goals, for each of the three departments, that would help the organization further the implementation of VBP. |
COMPETENT
The candidate provides a logical discussion, with adequate detail, of goals, for each of the three departments, that would help the organization further the implementation of VBP. |
HIGHLY COMPETENT
The candidate provides a logical discussion, with substantial detail, of goals, for each of the three departments, that would help the organization further the implementation of VBP. |
B3:ATTAINING QUALITY
| UNSATISFACTORY/NOT PRESENT
The candidate does not provide a reasonable description of how each of the goals chosen in part B2 will help attain quality outcomes in both patient care and reimbursements over the next three years. |
DOES NOT MEET STANDARD
The candidate provides a reasonable description, with no support, of how each of the goals chosen in part B2 will help attain quality outcomes in both patient care and reimbursements over the next three years. |
MINIMALLY COMPETENT
The candidate provides a reasonable description, with limited support, of how each of the goals chosen in part B2 will help attain quality outcomes in both patient care and reimbursements over the next three years. |
COMPETENT
The candidate provides a reasonable description, with adequate support, of how each of the goals chosen in part B2 will help attain quality outcomes in both patient care and reimbursements over the next three years. |
HIGHLY COMPETENT
The candidate provides a reasonable description, with substantial support, of how each of the goals chosen in part B2 will help attain quality outcomes in both patient care and reimbursements over the next three years. |
B4:CRITICAL KEY POINTS
| UNSATISFACTORY/NOT PRESENT
The candidate does not identify the key points for the strategic plan that are critical for the staff to understand and embrace. |
DOES NOT MEET STANDARD
Not applicable. |
MINIMALLY COMPETENT
Not applicable. |
COMPETENT
Not applicable. |
HIGHLY COMPETENT
The candidate identifies the key points for the strategic plan that are critical for the staff to understand and embrace. |
B4A:MARKETING THE KEY POINTS
| UNSATISFACTORY/NOT PRESENT
The candidate does not provide a logical discussion of how to market the key points of the plan to staff members. |
DOES NOT MEET STANDARD
The candidate provides a logical discussion, with no detail, of how to market the key points of the plan to staff members. |
MINIMALLY COMPETENT
The candidate provides a logical discussion, with limited detail, of how to market the key points of the plan to staff members. |
COMPETENT
The candidate provides a logical discussion, with adequate detail, of how to market the key points of the plan to staff members. |
HIGHLY COMPETENT
The candidate provides a logical discussion, with substantial detail, of how to market the key points of the plan to staff members. |
B5:ETHICAL CLINICAL AND ETHICAL BUSINESS PRACTICES
| UNSATISFACTORY/NOT PRESENT
The candidate does not provide a relevant reflection of how ethical clinical and ethical business practices will be incorporated into the strategic plan. |
DOES NOT MEET STANDARD
The candidate provides a relevant reflection, with no detail, of how ethical clinical and ethical business practices will be incorporated into the strategic plan. |
MINIMALLY COMPETENT
The candidate provides a relevant reflection, with limited detail, of how ethical clinical and ethical business practices will be incorporated into the strategic plan. |
COMPETENT
The candidate provides a relevant reflection, with adequate detail, of how ethical clinical and ethical business practices will be incorporated into the strategic plan. |
HIGHLY COMPETENT
The candidate provides a relevant reflection, with substantial detail, of how ethical clinical and ethical business practices will be incorporated into the strategic plan. |
B6:COORDINATING EVENTS
| UNSATISFACTORY/NOT PRESENT
The candidate does not provide a logical explanation of how to coordinate informational and educational events for the three departments identified in part B1. |
DOES NOT MEET STANDARD
The candidate provides a logical explanation, with no detail, of how to coordinate informational and educational events for the three departments identified in part B1. |
MINIMALLY COMPETENT
The candidate provides a logical explanation, with limited detail, of how to coordinate informational and educational events for the three departments identified in part B1. |
COMPETENT
The candidate provides a logical explanation, with adequate detail, of how to coordinate informational and educational events for the three departments identified in part B1. |
HIGHLY COMPETENT
The candidate provides a logical explanation, with substantial detail, of how to coordinate informational and educational events for the three departments identified in part B1. |
B7:TIMELINE
| UNSATISFACTORY/NOT PRESENT
The candidate does not provide a timeline to ensure that VBP is addressed over the next three years. |
DOES NOT MEET STANDARD
Not applicable. |
MINIMALLY COMPETENT
Not applicable. |
COMPETENT
Not applicable. |
HIGHLY COMPETENT
The candidate provides a timeline to ensure that VBP is addressed over the next three years. |
C1:MOST PERTINENT COMPONENTS
| UNSATISFACTORY/NOT PRESENT
The candidate does not provide an executive summary as a separate document for key stakeholders and critical department leaders that includes a description of the components of VBP that are most pertinent to the organization. |
DOES NOT MEET STANDARD
Not applicable. |
MINIMALLY COMPETENT
The candidate provides an executive summary as a separate document for key stakeholders and critical department leaders that includes a description, with insufficient detail, of the components of VBP that are most pertinent to the organization |
COMPETENT
Not applicable. |
HIGHLY COMPETENT
The candidate provides an executive summary as a separate document for key stakeholders and critical department leaders that includes a description, with sufficient detail, of the components of VBP that are most pertinent to the organization |
C2:PREPARATION FOR IMPLEMENTATION
| UNSATISFACTORY/NOT PRESENT
The candidate does not provide an executive summary as a separate document for key stakeholders and critical department leaders that includes the preparation that the three departments chosen in part B1 will need for the implementation of VBP in the next three years. |
DOES NOT MEET STANDARD
Not applicable. |
MINIMALLY COMPETENT
The candidate provides an executive summary as a separate document for key stakeholders and critical department leaders that includes, with insufficient detail, the preparation that the three departments chosen in part B1 will need for the implementation of VBP in the next three years. |
COMPETENT
Not applicable. |
HIGHLY COMPETENT
The candidate provides an executive summary as a separate document for key stakeholders and critical department leaders that includes, with sufficient detail, the preparation that the three departments chosen in part B1 will need for the implementation of VBP in the next three years. |
C3:NECESSARY EDUCATION AND TRAINING
| UNSATISFACTORY/NOT PRESENT
The candidate does not provide an executive summary as a separate document for key stakeholders and critical department leaders that includes a discussion of the education and training necessary to prepare the staff in the departments chosen in part B1 for implementation of VBP. |
DOES NOT MEET STANDARD
Not applicable. |
MINIMALLY COMPETENT
The candidate provides an executive summary as a separate document for key stakeholders and critical department leaders that includes a discussion, with insufficient detail, of the education and training necessary to prepare the staff in the departments chosen in part B1 for implementation of VBP. |
COMPETENT
Not applicable. |
HIGHLY COMPETENT
The candidate provides an executive summary as a separate document for key stakeholders and critical department leaders that includes a discussion, with sufficient detail, of the education and training necessary to prepare the staff in the departments chosen in part B1 for implementation of VBP. |
D:SOURCES
| UNSATISFACTORY/NOT PRESENT
When the candidate uses sources, the candidate does not provide in-text citations and references. |
DOES NOT MEET STANDARD
When the candidate uses sources, the candidate provides only some in-text citations and references. |
MINIMALLY COMPETENT
When the candidate uses sources, the candidate provides appropriate in-text citations and references with major deviations from APA style. |
COMPETENT
When the candidate uses sources, the candidate provides appropriate in-text citations and references with minor deviations from APA style. |
HIGHLY COMPETENT
When the candidate uses sources, the candidate provides appropriate in-text citations and references with no readily detectable deviations from APA style, OR the candidate does not use sources. |
