US. National Association of Children's Hospitals and Related Institutions (NACHRI)
The non-profit advocacy group for pediatric hospitals in the _________.
Minimally Invasive Surgery
Use of fiber optics, guide images, microwaves and other technologies to do surgery rather than cutting large sections of tissue.
Ambulatory Surgery Center (ASC)
Normally costs 50% less than an inpatient hospital procedure because they practice line by line billing.
HHS
Department of Health and Human Services.
Laparoscopy
Laparotomy performed with a laparoscope that makes a small incision to examine the abdominal cavity (esp. ovaries and Fallopian tubes).
Endoscopy
Inspection of body organs or cavities using a lighted scope that may be inserted through an existing opening or through a small incision.
Phacoemulsification
Method to remove cataracts in which an ultrasonic needle probe breaks up the lens, which is then aspirated.
Arthroscopy
A minimally invasive operation to repair a damaged joint.
Natural Orifice Surgery
Abdominal surgery where the entrance wound is through either the stomach or through the vagina.
Single Payer System
Government run healthcare system. Healthcare system is made up of a) cost, b) access and c) quality.
Altruism
Helping people.
Supply Chain
Taking raw materials and processing them until they become a useable good.
Evidence Based Medicine
Used EMR's to compile statistics to determine the "best practice."
Compliance
The % of goods and services used in hospitals that have been negotiated with the GPO's.
Indemnity Insurance
"Standard' type of health insurance individuals can purchase, provides comprehensive major medical benefits and allows insured individuals to choose any physician or hospital when seeking medical care.
Preferred Provider Organization (PPO)
A prepaid health insurance plan in which providers agree to deliver services for discount fees; patients can go to any provider, but using nonparticipating providers results in higher costs to the patient. Part of managed care.
Health Maintenance Organization (HMO)
A prepaid health insurance plan in which patients receive health care from designated providers. Part of managed care.
National Insurance Costs
The average US family pays $14,000 a year for insurance coverage with 3/4 being paid by the employer and 1/4 being plaid by the employee.
Patient Protection and Affordable Care Act
This is the health care reform law. Focuses on reform of the private health insurance market; providing better coverage for those with pre-existing conditions; improving prescription drug coverage in Medicare.
Corporate Structure of Hospitals
Department Heads
Medical Executive Committee
Board
Accountable Care Organization
A term used in the Patient Protection and Affordable Care Act to define an ideal healthcare organization able to have very low costs caused by successful capitalization on medical goods and services.
Common Law
A civil law established by following earlier judicial decisions.
Statutes
Laws enacted by a state or federal legislature that in certain cases can overwrite common law.
Executive Order
A rule issued by the president that has the force of law.
Civil Law
Wrongs against a particular person or organization.
Tort
Any wrongdoing for which an action for damages may be brought.
declining reimbursement
Less resources to recruit, compensate, and develop workforce.
declining supply of workers
Shortage of skilled workers.
increasing population need
Increased volumes of patients and workload for HSO.
external pressure on HSO's
HR must ensure high performance in HSO.
National Labor Relations Act
1935 law that provides bargaining units and collective bargaining in hospitals and health service organizations.
Fair Labor Standards Act
1938 law regulating minimum wage, overtime pay, and minimum worker ages.
Equal Pay Act
1963 law prohibits discrepancies in pay between men and women.
Civil Rights Act
1964 law that prohibits discrimination based on gender, race, or religion.
Age Discrimination in Employment Act
1967 law that prohibits discrimination of employees 40 years and up.
Occupational Safety and Health Act
1970 law that requires employers to maintain a safe workplace and adhere to standards specific to healthcare employers.
Rehabilitation Act
1973 law that protects rights of handicapped.
Employee Retirement Income Security Act
1973 that grants protection to employees for retirement benefits to which they are entitled.
Pregnancy Discrimination Act
1978 law stating that pregnancy is considered a medical condition and prohibits exclusion of pregnancy in benefits and leave policies.
Consolidated Omnibus Budget Reconciliation Act (COBRA)
1986 law that gives benefits like health coverage for a limited time due to various circumstances like termination, layoff, death, reduction of hours per week, and divorce.
Immigration Reform and Control Act
1986 law that establishes penalties for employees who knowingly hire illegal aliens.
Worker Adjustment and Retraining Notification Act
1986 law that requires employers who will make a mass layoff or plant closing to give 60 days advance notice to affected employees.
Americans with Disabilities Act
1990 law that gives people with disabilities access to public services and requires employers to provide reasonable accommodation for applicants and employees.
Family Medical and Leave Act
1993 law that permits employees in organizations to take up to 12 weeks of unpaid leave each year for family or medical reasons.
Health Insurance Portability and Accountability Act
2003 law that guarantees employees protection from outside access to personal health info and limits employers' ability to use employee health info under health insurance plans
conceptual skills
Ability to critically analyze and solve complex problems.
technical skills
Expertise or ability to perform a specific work task.
interpersonal/human relation skills
Enables a manager to communicate with and work well with other individuals.
functional organizational structure
Most common organizational structure; pyramid shaped; used in larger organizations; deep vertical structures; strict chain of command ensures that communication and assignment and evaluation of tasks are carried out; used most frequently in HSO's.
matrix management method
Administrative structure; dual authority system where individuals are assigned to complete specific work tasks; advantages are improved coordination and communication, also increases flexibility of organization to carry out work.
product/service line management
Organized around selected services to control service delivery; Advantages are resource control, accountability, enhanced clinical quality of service.
environment for HSO's
Entities and influences outside of the organization's boundaries.
open systems
Organizations which are affected by, and also affect, their environment.
exchange relationships
Transaction between 2+ organizations where something of value is exchanged and both gain value.
input/output management model
Management acquires inputs, uses inputs to provide services, and creates outputs.
managers
Persons appointed to positions of authority who enable others to do their work effectively, who have responsibility for resource utilization, and who are accountable for work results.
line managers
Those that supervise other employees.
staff managers
Those that carry out work and advise their bosses.
Planning
Organizing
Staffing
Controlling
Decision-Making
Directing
6 management functions
organizing
Establishing authority and responsibility management.
staffing
Acquiring and retaining human resources.
directing
Initiating action in the organization by leading, motivating, and communicating.
controlling
Monitoring, adjusting, and improving aggregate performance.
decision making
Evaluating alternatives and making choices.
managerial tasks
Include core tasks, routine add-ons, and specialty add-ons.
Self
Team/Work Unit
Organization
domains of management
organizational culture
Ingrained patterns of shared beliefs, values and behaviors, with associated symbols and rituals, that are acquired over time by members.
direct care
Deals directly with the patients such as a hospital, nursing home, physician practice, and assisted living facilities.
indirect care
Supports the care of individuals through products and services made available to direct care settings. Ex) Consulting firms, associations, pharmaceutical companies, and medical suppliers.
70%
Percentage of expenditures in healthcare that go to pay the workforce.
contracts
The most basic/important item in business relationships.
restrictive covenant
Worst provision for the employee in a contract.
at will contract w/ or w/o restrictive covenant
What is the best deal for employer in a contract?
contract with money/stability and free agency
What is the best deal for you in a contract?
patients and skills
As a physician what are your bargaining tools in a contract?
covenant
Restriction on free agency.
integration clause
Tells us what the whole deal is.
ADR provision
How we're going to resolve disputes.
maximum notice possible and severance
What provisions are best for you in a termination without cause?
fairness and consistency
What are the 2 key principles in hiring?
business plan
Good place to start on how to set up your practice:
Executive summary
Mission statement
Ownership/management
Market analysis
Financing
Projected patient base/referral sources
Services
Location
Assets
Operational plan
Human Resources
Marketing
reimbursements for physician services
These must be credentialed!
joint several liability
Risk is that if one person screws up, all in the partnership are liable.
LLP-limited liability partnership
Risk is that liability is limited individually.
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