For your first assignment, you will conduct a case study analysis.Following the guidelines for a case study analysis in Appendix A of your textbook, prepare a written report of the case.
The use of APA 7th Ed. Guidelines is required. Additionally, it is expected that you will incorporate at least two references in your case study.
Strategies for Dealing with Health Care Reform
Nancy H. Shanks
The CEO of North Eastern Hospital (NEH), Jim James, had been playing the waiting game, assuming that he had plenty of time to prepare for how his institution would be impacted by the Affordable Care Act (ACA). When the Supreme Court upheld the constitutionality of President Obama’s signature legislation in June 2012, Jim realized he and his staff needed to quickly rethink the hospital’s position and shift strategies. While they had initially seen the health care reform provisions of the ACA as burdensome, now he wanted the staff to think about the opportunities that it offered and how it could enhance NEH and help it to fulfill its mission in serving the community.
The more Jim read and thought about the provisions of the new law, the more convinced he became of the benefits. Since a primary goal of the ACA was to bring the uninsured into coverage, large number of uninsured in the community would soon have access to care. And, with insurance companies being required to provide coverage for those with preexisting conditions, these folks would also have access.
There were many negative stereotypes associated with both groups. While some of these people were indeed very ill, it was also clear that the fact that people didn’t have insurance did not necessarily mean they were sick. In reality, many were healthy individuals who, for whatever reason, were uninsured. Some were seasonal workers in organizations that didn’t provide coverage to their employees, others opted not to buy coverage, and there were those who just could not afford it and would now be subsidized. Additionally, some with preexisting conditions had in the past been denied insurance coverage on the basis of relatively minor problems, such as sinusitis, a prior knee injury, removal of a small benign tumor, and so on.
This looked to Jim like a bonanza. Jim wanted to find ways to connect these groups to his hospital, as well as its associated outpatient clinics and excellent pool of physicians and other health care professionals. This led him to thinking about new programs, modifying existing programs, developing marketing strategies, finding ways to capitalize on the pent-up demand for services in the short run, and becoming the provider of choice in the long run.
1.What should NEH do? Would you recommend developing new programs? Or, should existing programs be expanded to meet the increased demand? Provide the rationale for what you propose.
2.Are there areas of the hospital where demand might be reduced? For example, many of the uninsured may have used the ER as their point of access to care in the past. What would you propose to change this behavior and to address issues relating to the ER?
3.What marketing strategies might be developed to attract this new clientele?
4.Have there been more recent changes to the ACA on which you would recommend the hospital focus? Be specific.
5.Have other changes taken place in your state with regard to other groups of patients, such as those enrolled in Medicaid and the Children’s Health Insurance Program (CHIP)? How can NEH respond to meet the needs of these groups?
Abelson, R. (2012, June 21). Billions of dollars are in play over health care law. New York Times. Retrieved from http://www.nytimes.com/2012/06/22/health/billions-of-dollars-in-play-over-health-care-law.html?ref=reedabelson
Affordable Care Act. See http://www.healthcare.gov/index.html
Buchbinder, S. B., & Shanks, N. H. (Eds.). (2012). Introduction to health care management (2nd ed.). Burlington, MA: Jones & Bartlett.
Clemans-Cope, L., Kenney, G. M., Buettgens, M., Carroll, C., & Blavin, F. (2012). The Affordable Care Act’s coverage expansions will reduce differences in uninsurance rates by race and ethnicity. Health Affairs, 31(5), 920–930.
Kaiser Family Foundation. (2010). Mapping the effects of the ACA’s health insurance coverage expansions. Retrieved from http://healthreform.kff.org/en/coverage-expansion-map.aspx
Liptak, A. (2012, June 28). Supreme Court upholds health care law, 5-4, in victory for Obama. New York Times. Retrieved from http://www.nytimes.com/2012/06/29/us/supreme-court-lets-health-law-largely-stand.html?ref=health&pagewanted=print
Tavernise, S. (2012, June 21). Those already ill have high stake in health ruling. New York Times. Retrieved from http://query.nytimes.com/gst/fullpage.html?res=9C07E0DD163BF930A15755C0A9649D8B63&ref=sabrinatavernise
Vega, T. (2012, June 21). Insurers seek to soften their image, no matter how court rules on health act. New York Times. Retrieved from http://www.nytimes.com/2012/06/22/us/politics/insurance-companies-are-trying-to-soften-their-image.html?ref=tanzinavega
Weaver, C. (2012, July 5). Ruling underscores hospitals’ strategy. Wall Street Journal. Retrieved from http://professional.wsj.com/article/SB10001424052702304441404577481060091946508.html
White House. (2012). The Affordable Care Act is helping millions of Americans like you. Retrieved from http://www.whitehouse.gov/the-press-office/2012/06/28/fact-sheet-affordable-care-act-secure-health-coverage-middle-class
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