Hospitals And Health Systems: What They Are and How They Work

Description

Hospitals and Health Systems: What They Are and How They Work takes a practical approach to explaining the history, development, and structure of modern health care institutions. Early chapters discuss the history of the hospital, Medicare and Medicaid, health insurance, as well as managed care and reimbursement to set the context for the modern hospital and health system network. The text moves on to explain how hospital mergers, reaction to cost escalation, and government and religious affiliations have led to the emergence of health systems, of which hospitals are an important part. Finally, it delves into operating today's modern hospital, including care structure and organization, direct patient care, staffing, physical facility, business activities (billing, accounting, health information management, electronic health records, etc.), and unions. Written for undergraduate courses in Hospital and/or Health Systems Administration, this short text can be easily used alongside a Health Management text or by anyone looking to understand how today's hospitals and health care system evolved and now operates. Key Features: * Contributions by experts from both professional practice and academia provide fresh insights and different perspectives * Each chapter offers key terms, learning objectives, and chapter summaries to enhance learning * End-of-chapter review and discussion questions encourage critical thinking Cover......Page 1 Hospitals and Health Systems......Page 2 Copyright......Page 3 Contents......Page 4 Preface......Page 8 About the Author......Page 10 Contributors......Page 12 The Earliest Years of Hospitals......Page 14 Early American Hospitals......Page 17 Brief Chapter Summary......Page 21 References......Page 22 Entering the 20th Century......Page 24 The “Modern” Hospital Takes Its Place......Page 26 Brief Chapter Summary......Page 28 References......Page 29 Era of Extensive Change......Page 30 Hill-Burton Arrives Upon the Scene......Page 31 Classification......Page 32 Trends in General Acute-Care Community Hospitals......Page 33 A New Era of Medicine......Page 35 The Healthcare Landscape Forever Altered......Page 36 Questions for Review and Discussion......Page 37 References......Page 38 Introduction—Medicare and Medicaid......Page 40 By the Numbers......Page 42 Initial Impacts......Page 47 Major Concerns About Cost Control......Page 48 The Role of the Affordable Care Act......Page 51 Brief Chapter Summary......Page 53 References......Page 54 Beginnings of Managed Care: The Pre-Paid Health Plans......Page 58 Managed Care as Agent of Change......Page 63 Brief Chapter Summary......Page 64 Additional Resources......Page 65 Chapter 6 Health Benefits Coverage and Types of Health Plans......Page 66 Introduction......Page 67 Health Benefits Coverage......Page 68 Sources of Benefits Coverage and Risk......Page 73 Types of Payer Organizations......Page 79 Provider-Owned or Sponsored Health Plans......Page 90 Brief Chapter Summary......Page 93 Note......Page 94 Following the Money......Page 96 Introduction to a Changing Landscape: Volume to Value......Page 97 A History of Hospital Care Reimbursement Models......Page 99 Federal Legislation Affecting Reimbursements......Page 105 The Patient Protection and Affordable Care Act (PPACA)......Page 106 The Future of the PPACA......Page 109 Brief Chapter Summary......Page 110 References......Page 111 Chapter 8 Is Bigger Better? Hospitals and “Merger Mania”......Page 114 The Macro View: Mergers, Affiliations, and Other Organizational Combinations......Page 115 The Micro View: Adjusting to the Blended Organization......Page 121 Conclusion: When the Dust Settles......Page 126 Questions for Review and Discussion......Page 127 References......Page 128 Appendix A: Healthcare Partnership Continuum......Page 129 Introduction......Page 132 Rationale for Hospital Mergers......Page 133 Hospital Classifications......Page 134 Hospital Ownership......Page 136 The Changing Landscape of Hospital Organizations......Page 137 Brief Chapter Summary......Page 142 Questions for Review and Discussion......Page 143 References......Page 144 Introduction......Page 148 Collaborative Agreements......Page 149 Legal and Regulatory Oversight of Mergers and Acquisitions......Page 152 Supply Chain Management......Page 153 The Role of HR in a Merger–Acquisition Activity......Page 154 Conclusion......Page 155 Brief Chapter Summary......Page 156 Questions for Review and Discussion......Page 157 References......Page 158 Additional Resources......Page 159 Common Organizational Structure Concepts......Page 160 Hospital Governance......Page 164 Doorways into the Acute Care Hospital......Page 167 Brief Chapter Summary......Page 168 References......Page 169 Introduction......Page 170 The Medical Staff......Page 171 Nursing Services......Page 172 The Clinical Laboratory and the Pathologist......Page 181 Diagnostic Imaging and Therapeutic Radiology Departments......Page 183 Physical Therapy......Page 185 Respiratory Therapy......Page 186 Pharmacy......Page 187 Questions for Review and Discussion......Page 189 Health Industry Changes......Page 190 Nursing......Page 191 Physical Therapists......Page 198 Occupational Therapist......Page 199 Pharmacist......Page 200 Allied Health......Page 201 Questions for Review and Discussion......Page 202 References......Page 203 Introduction......Page 206 Laws, Codes, and Standards......Page 207 Plant- and Environmental-Related Departments and Services in Hospitals......Page 208 Plant Engineering and Maintenance......Page 210 Biomedical Engineering (Medical Equipment)......Page 211 Physical Needs of Hospitals in the 21st Century......Page 212 Brief Chapter Summary......Page 213 References......Page 214 The Business of Medicine......Page 216 In the Matter of Budgeting and Budgets......Page 218 Challenges in Health Care......Page 219 Electronic Medical Records Versus Electronic Health Records......Page 220 Health Insurance Portability and Accountability Act......Page 222 Questions for Review and Discussion......Page 223 References......Page 224 Can Unionization Be Avoided?......Page 226 Health Care: More and More a Special Case......Page 228 System Growth and Increased Vulnerability......Page 230 The Potential for Communications Problems......Page 231 The Organizing Approach......Page 232 Unequal Positions......Page 233 A Manager’s Role......Page 234 Shifting Ground Rules......Page 236 If the Union Wins......Page 237 Decertification......Page 238 Questions for Review and Discussion......Page 239 Note......Page 241 Glossary......Page 242 Index......Page 248