Biomedical subjects
Publications and source records attributed to R C Nauert.
The health care industry has evolved tremendously in recent years. It will experience even greater changes in the 21st century. Evolution will occur in health care delivery, system formation, and the roles played by government, the insurance industry, and organized business. Major focuses will be on management, competition, and quality.
Physicians and hospitals are rapidly organizing integrated systems to compete more successfully in the new health care business arena. The preferred parent structure has been the management services organization (MSO). Notable factors have produced significant progress or pitfalls. Success is driven by the thoughtfulness of planning, the depth of management, and the quality of care.
The radiologic segment of the health care industry has grown dramatically in size and functions. The focus on cancer and heart disease has made it a key core functional area for health systems and physician groups. Aggressive growth plans are based on key strategies, high demand services, and other critical success factors.
Behavioral health care is an important component of health system development. Unfortunately, many systems believe it is unmanageable in relation to both cost and effectiveness. The keys to success include thorough planning and modernized oversight procedures.
Managed behavioral health care is a key component of integrated regional delivery systems. Mental health and chemical dependency services are of growing importance in developing insurance programs and establishing health systems. Primary features include full involvement of the medical community, development of a free-standing organization, joint ventures with existing entities, and effective contract negotiations.
Purchasers and consumers of health care will increasingly refine their definitions of "quality" and the "cost" associated with treatment. The beneficial relationship of these concepts is "value." In the new era of managed care, those providers who offer the best value will succeed. Low-value producers will fail. Understanding buyer perceptions and expectations of value will become increasingly important as markets mature and integrated systems vie for dominance.
This article reviews the threatened state of academic medical centers in the new era of managed care. Particular emphasis is given to the onslaught of capitation and risk sharing. Related strategies of quality enhancement, system development, and cost reduction are also discussed.
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Because of governmental challenges, not-for-profit hospitals can no longer take for granted their right to be tax exempt. The Internal Revenue Service is auditing nearly 1,500 tax-exempt healthcare organizations to determine how accurately they are reporting unrelated business income. At greatest risk are those hospital systems that have become overly acquisitive or have strayed from the charitable mission that originally entitled them to tax exemption. To protect their tax-exempt status, currently exempt healthcare institutions must be careful that any activities, such as joint ventures and affiliate corporations, conform to their charitable mission. In the face of tougher legislation and Federal scrutiny, hospitals must make sure they are devoted to and performing a charitable purpose if they want to keep their tax-exempt status.
In recent years, CFOs have become an integral part of the healthcare organization's strategic planning process. Although not the leader in the process, CFOs should assume a role of review, reaction, and projection. Furthermore, they should oppose any venture that would weaken the financial strength of the institution--whether or not they support the venture on social grounds. The CFO's responsibility in planning is to improve the financial strength of the organization, using support documentation, thorough preparation, and logic. The CEO's concern for community needs and desire to pursue a new business should be tempered by the CFO's financial and economic judgment.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Recent years have seen increasing business concern over the cost of employee health care, according to authors John McCally and Roger Nauert. On average, 50 percent of employer profits are being absorbed by health care costs, thus direct contracting has now emerged as one of the major trends of the '90s and beyond.