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Sutter Health is a non-for-profit community based healthcare and hospital system based in Sacramento, CA. This system serves patients and their families in more than 100 Northern California cities and towns, Sutter Health doctors, hospitals and other health care service providers join resources and share expertise to advance health care quality and access. The organization takes its name from California pioneer John Sutter whose namesake fort was one of Sacramento’s original European settlements. In response to the influenza epidemic of 1918, community leaders constructed the first Sutter Hospital in the vicinity of the fort, replacing an old adobe house that had previously served as a makeshift hospital. Sutter Medical Center, Sacramento occupies this site today.
Other Sutter Health-affiliated hospitals date back to the 1800’s and was some of Northern California’s earliest health care providers. In 1866, the predecessor of today’s Sutter Medical Center of Santa Rosa opened its doors to residents of Sonoma County. Today in the United States there are nearly 47 million Americans uninsured and 80 percent of that comes from working families. The article by Souza and McCarty, “From Bottom to Top: How One Provider Retooled its Collections,” covers how one of Northern California’s largestproviders, Sutter Health, approached implementing a new strategy to increase collections. In collecting payments from new patients, services provided, comes from the need to implement new strategies on how and when to collect the payments. Sutter Health have made a successful new program to implement and define most problems within their A/R department, developed solutions to their problems and have recognized the need to ensure the program is continuo...
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... be able to compare their results to that of their peers.
The way in which healthcare organizations need to implement a new strategy into their A/R departments comes from the realization that time of registration is the best time to ask the patient for payment (Souza& McCarty, 2007). Front end staff in the healthcare industry has not been responsible for collecting payment from the patient before services are rendered; that responsibility has been that of the A/R staff. There have been other healthcare organizations that have found solutions to problems within their A/R departments. Sutter Health was successful in identifying problems in their A/R department, finding solutions for those problems in their A/R department and implementing their solution program into their company. Sutter Health has set themselves up for continued success in their A/R department.
On the basis of the clinic’s previous collections experience, Dough was able to convert billings for medical services into actual cash collections. On average, about 20% of the clinic’s patients pay immediately for services rendered. Third-party payers pay the remaining claims, with 20% of the payments made within 30 days and the 60% remainder (of total billings) paid within 60 days. For monthly budgeting purposes, 20% are assumed to be collected one month after the billing month, and 60% are assumed to be collected two months after the billing month.
Sutter Health has 24 hospitals, 34 surgery centers and more than 5,000 physicians in its network (Sutter
Due to the increasing financial implications, patient satisfaction has become a growing priority for health care organizations, as well as transitioning the health care organization’s philosophy about the delivery of health care (Murphy, 2014). This CMS value based purchasing initiative has created a paradigm shift in health care in which leaders and clinicians must focus on patient centered care and the patient experience which ultimately will result in better outcomes. Leaders and clinicians alike must be committed to the patient satisfaction. As leaders within the organization, these groups must be role models and lead by example for front-line staff. Ultimately, if patients are satisfied, they are more likely to be compliant with their treatment plans and continue to seek follow up care with their health care provider, which will result in decreased lengths of stay, decreased readmissions, increased referrals and decreased costs (Murphy, 2014). One strategy employed by health care leaders to capture the patient experience, is purp...
Lemuel Shattuck, teacher, historian, statistician, publisher, and visionary, established the Lemuel Shattuck Hospital in 1869. His plan was the first to identify major public health issues including the recommendation to establish the accurate keeping of health records and vital public health statistics to use as tools to fight disease. In 1869, his vision led to the nation’s first State Board of Health that was established in Massachusetts. In order to carry out their mission, Lemuel Shattuck Hospital delivers compassionate medical and psychiatric care to patients requiring multi-disciplinary treatment and support which promotes their health, well-being, rehabilitation and recovery.
Describe the differences between nonprofit and for-profit hospitals. William & Torres provided a table to reflect hospital ownership, and noted that some hospitals, while owned by one type of entity, may be operating under a contract by another entity, such as a hospital management company (Williams & Torres, page 185). Some of the largest groups of hospitals in the nation are nonprofit community hospitals (Williams & Torrens, page 185). Nonprofit entities, including hospitals, function under special provisions of corporation law in each state, and under federal and state tax provisions that recognize their community service function (Williams & Torrens, page 185).
Miller, H. D. (2009). From volume to value: better ways to pay for health care. Health Affairs
In order to fully understand the uninsured and underinsured problem that hospital administrators face the cause must be examined. The health outcomes of uninsured individuals are generally worse than those who are insured. Uninsured persons are more likely to experience avoidable hospitalizations, diagnosed at later stages of disease, hospitalized on an emergency or urgent basis, and more seriously ill upon hospitalization (Simpson, 2002) Because the uninsured often lack an ongoing relationship with a health-care provider, they are less likely to receive preventive care and diagnostic tests (Kemper, 2002). Many corporations balance their budget through cost cuts and other moves, but have been slammed with an increasing load of uninsured patients, coupled with reduced payments from government and private insurance programs. In 2000, 564,476 uninsured patients came through Health and Hospitals Corporations health care centers, a 30 percent increase from 1996. In the same period, Congress reduced Medicare reimbursements to hospitals, while Medicaid reimbursements to primary care clinics remained basicall...
The University of California – San Francisco Medical Center is one the best hospitals in the country. In 2010 the hospital was the seventh best hospital out of 100’s of others. How does a hospital reach this level of success? A hospital such as UCSF they have to be willing and able to find better and new ways to approach the care for their patients. Superb patient care is only one of the reasons why UCSF is one of the best. The innovative research and the extensive education in the Science of Health at their medical school are more reasons. UCSF Medical Center has been known to specialize in many of areas of medicine but there are areas they are most popular for. They also have many strategic plans that are already being putting in affect to better their hospital reputation and for the coming years.
There are several factors that contribute to the complexity of the revenue cycle. Frequent changes in contracts with payers, legislative mandates, and managed care are just a few examples of reasons why revenue cycle in the healthcare industry is so complex. Furthermore, the problems that arise in the steps of the revenue cycle further complicate the whole process. For example, going through the steps of the revenue cycle efficiently is extremely difficult when it is managed by poorly trained personnel. Furthermore, if a healthcare provider does not have the proper information system to track patient records and billing, receiving reimbursement can become difficult. In addition, one of the main factors that delay payments is denial from the insurance companies. The reason for Denial includes incorrect coding, the certain sequence of care and medical necessity or even delay in submitting claims. Lastly, inefficient patient correspondence can not only hinder the process of revenue cycle but also result in many patient complaints (Wolper, 2004).
Barton, P.L. (2010). Understanding the U.S. health services system. (4th ed). Chicago, IL: Health Administration Press.
Niles, N. J. (2011). Basics of the U.S. health care system. Sudbury, MA: Jones and Bartlett.
In this paper there will be an understanding of the California Sutter health system, which will in tail about the efforts of the California Sutter health system to increase the point of service collections. Not to mention the improvement of the overall revenue cycle. Though, not to go into grave detail on what the paper is fully about, this will be said though, that in order for some of the things to happen there were steps to be taken such as the measure of performance in benchmarks. Then to mention it will also talk about how each registration is analyzed while using the rules of engineering to show what problems their patients leave at the registration desk. With that being said lets dive right into the paper following the abstract there
It is enthralling to note that in spite of the advances in healthcare systems, such as our hospital’s ability to provide patients with lower cost, managed One being the Health Maintenance Organizations (HMO), which was first proposed in the 1960s by Dr. Paul Elwood in the "Health Maintenance Strategy”. The HMO concept was created to decrease increasing health care costs and was set in law as the Health Maintenance Organization Act of 1973, after promotion from the Nixon Administration. HMO would, in exchange for a fee, allow members access to employed physicians and facilities. In return, the HMO received market access and could earn federal development funds.
Many individuals have the opportunity to choice a healthcare organization for their healthcare needs. One in particular is United Healthcare group which provides individuals with the most ideal care. As well as to work to give individuals access to the quality care they require at a reasonable price (UnitedHealth Group, 2015). They give data, direction and apparatuses to individuals to settle on more educated choices about their wellbeing, health insurance and prosperity (UnitedHealth Group, 2015). These choices have deep rooted, once in a while life-characterizing, outcomes. United Healthcare grasp this position of trust and the basic social obligation they need to serve individuals ' medical needs in the United
Shapiro, K., Peterman, N., & Wolnerman, D. (2013). Turmoil in the health care industry: what about the patients. The Americas Restructuring and Insolvency Guide, 100-106. Retrieved from http://www.americasrestructuring.com/08_SF/p100-106%20Turmoil%20in%20the%20healthcare%20industry.pdf