Health Care Administration: Planning Implementing & Managing Organized Delivery Systems

by Wolper, Lawrence F.

• ISBN13: 9780763731441
• ISBN10: 0763731447
• Edition: 4th
• Format: Hardcover
• Copyright: 2003-11-01
• Publisher: Jones & Bartlett

Summary

Health Care Administration: Planning, Implementing, and Managing Organized Delivery Systems, Fourth Edition continues to be the definitive guide to contemporary health administration. It provides comprehensive coverage of detailed functional, technical, and organizational matters that pertain to organized delivery systems. It also extensively covers matters that relate to hospitals and functions that occur at the hospital level. With revisions that reflect the emerging issues in health care, this classic text is a must-have for both health administration students and professionals.

Table of Contents

About the Author/Editor	p. xv
Contributors	p. xvii
Preface	p. xxi
Acknowledgments	p. xxv
Planning, Implementing, and Managing Organized Delivery Systems	p. 1
International Health Care: A 12-Country Comparison	p. 3
The Financing, Organization, and Outcomes from the Provision of Health Care	p. 4
Tax-Funded Models for Direct Provision of Health Services	p. 12
Tax-Funded Model for Indirect Provision of Health Services	p. 21
Compulsory Insurance Models for Indirect Provision of Health Services	p. 23
Mixed Models for Provision of Health Services	p. 30
Shared Concerns and Learning Opportunities	p. 42
Organized Delivery Systems	p. 55
Healthcare System Development	p. 56
System Characteristics	p. 59
The Impact of Managed Care	p. 61
System Integration	p. 63
System Performance	p. 68
A View from the Real World	p. 70
In-Depth Case Study: Southeast Medical Center	p. 78
Managerial Implications and Recommendations	p. 85
Legal Implications of Business Arrangements in the Healthcare Industry	p. 93
Legal Structure of the Healthcare Delivery System	p. 93
Federal Anti-Kickback Statute	p. 97
Physician Self-Referral--Stark Law	p. 104
Comparison of the Federal Anti-Kickback Statute to the Physician Self-Referral Act	p. 110
False Claims Act	p. 130
Professional Liability	p. 145
Antitrust Laws and the Healthcare Industry	p. 148
Other Considerations	p. 151
Stakeholder Management--Strategies and Styles	p. 157
Stakeholder Management Styles and Performance	p. 158
The Strategic Web	p. 159
Identification of Organizational Stakeholders	p. 161
Diagnosis of Key Stakeholder Relationships	p. 164
Types of Stakeholder Relationships	p. 168
Generic Strategies for Managing Stakeholder Relationships	p. 172
Strategy Implementation and Outcomes	p. 177
Stakeholder Management Styles: Changing the Focus to Types of Organizations	p. 178
Stakeholder Management Priorities	p. 179
Managerial Responsibility for Stakeholder Relationships	p. 183
Conclusion	p. 184
Financial Management of Organized Health Care Delivery Systems	p. 191
Financial Information Needs	p. 191
Understanding Financial Statements	p. 192
Types of Financial Statements	p. 193
Long-Range Decisions	p. 217
Short-Range Decisions	p. 230
Conclusion	p. 244
Present Value Tables	p. 247
Human Resources Management in Organized Delivery Systems	p. 249
Human Resources Management: Historical Background	p. 249
Functions and Responsibilities of the Human Resources Department	p. 252
Placement of the Human Resources Department in the Institution's Organizational Structure	p. 268
Future Direction of Human Resources Management	p. 284
The Effect of Managed Care and Mergers on Human Resources Management	p. 285
Great Places to Work	p. 291
Labor and Employment Laws Applicable to Organized Delivery Systems	p. 295
Introduction	p. 295
Federal and State Civil Rights Laws	p. 298
Affirmative Action/Federal Contractor Requirements	p. 302
Individual Employment Rights	p. 303
Wage and Hour Laws	p. 306
Employee Benefits in the Healthcare Industry	p. 312
Privacy Issues in the Workplace	p. 315
Safety in the Workplace	p. 318
Collective Bargaining and Protected Concerted Activities	p. 319
Employment Eligibility Verification	p. 327
Conducting an Effective Internal Investigation	p. 331
Employment Records and Recordkeeping	p. 337
The Management of Nursing Services	p. 349
The Evolving Practice of Nurse-Executives	p. 349
Organization of Nursing/Patient Care Services	p. 354
Changing Health Care Delivery Methods	p. 357
Emerging Models for Nursing Care Delivery	p. 363
New Competencies for Nurses in Executive Practice	p. 364
Challenges for Nurses in Executive Practice	p. 365
The Future of Nurse-Executive Practice	p. 370
Planning Healthcare Facilities and Managing the Development Process	p. 373
Background	p. 373
Facility Planning in Healthcare Systems	p. 374
Future Facility Planning Trends	p. 375
Facility Development Process	p. 378
Functional Considerations in Facility Planning	p. 383
Key Participants	p. 387
Design and Construction Approaches	p. 390
Conclusion	p. 392
Potential External Team Members and Responsibilities	p. 394
Financing of Healthcare Facilities	p. 397
Tax-Exempt Financings	p. 397
Pooled Financing	p. 406
Taxable Bonds	p. 407
Equity Financing as a Capital-Raising Technique	p. 408
Joint Venture Structures	p. 409
Legal Issues: Control and Liability Exposure	p. 410
Federal Income Taxation of a Business Corporation	p. 411
Federal Income Taxation of a Partnership and Limited Liability Corporation	p. 412
Sale as a Capital-Raising Technique	p. 413
Conversion	p. 413
Private Placements and Public Offerings of Securities	p. 414
Conclusion	p. 415
Marketing Healthcare Services	p. 417
Marketing Mission and Objectives	p. 418
The Competition Defined	p. 419
Business-to-Business Marketing	p. 423
Derived Demand	p. 425
Consumer Behavior: Information Search and Use	p. 427
Consumer Behavior: Differentiation	p. 431
Customer Retention	p. 434
Customer Satisfaction	p. 437
Data-Driven Marketing	p. 439
Health Care Information Systems: An Organized Delivery System Perspective	p. 443
An Organized Delivery System HCIS Infrastructure	p. 444
Trends in Organized Healthcare Delivery Systems	p. 445
Emergence and Scope of Organized Delivery System HCIS Technologies	p. 450
SSADM for Multiprovider HCIS Design and Development	p. 458
Management and Administration of Organized Delivery System HCISs	p. 466
Conclusion	p. 472
Management Engineering	p. 477
History	p. 478
Cost Containment	p. 481
Productivity Management	p. 483
Quality Control Program	p. 492
Management Engineering for Future Operations	p. 502
Ambulatory Care	p. 507
Ambulatory Care Services: Past and Present	p. 508
Organization and Management of Ambulatory Care Services	p. 525
Reimbursement	p. 528
Future Considerations	p. 542
Conclusion	p. 544
Managed Health Care	p. 547
What It is	p. 547
Introduction	p. 547
Forms of Bearing Risk for Medical Costs	p. 548
Types of Payor-Based Managed Health Care Organizations	p. 551
Managed Health Care Provider Organizations--Integrated Delivery Systems	p. 557
How It Works	p. 561
Introduction	p. 561
Provider Reimbursement	p. 561
Management of Utilization	p. 570
Benefits Administration and Claims Payment	p. 575
Finance and Underwriting	p. 578
Conclusion	p. 583
Ethical Considerations in the Provision of Healthcare Services and Investigational Research	p. 585
Tragic Choices	p. 588
Ethics in Human Clinical Investigation and in the Use of New Drugs and Devices	p. 591
Bioterrorism Preparedness	p. 609
The Broader Context of Bioterrorism	p. 614
The Specific Context of Terrorism	p. 616
Biological Agents	p. 617
Bioterrorism Preparedness by Healthcare Organizations	p. 621
Conclusion Regarding Preparedness	p. 629
Epilogue	p. 630
The Hospital in an Organized Delivery System	p. 635
The History of Hospitals	p. 637
Medicine and Hospitals as Political Factors	p. 637
Mesopotamia	p. 638
Greek Hospitals	p. 638
Indian Hospitals	p. 638
Roman Hospitals	p. 638
Islamic Hospitals	p. 639
The Middle Ages	p. 639
Hospitals during the Renaissance	p. 640
Hospitals on the American Continent	p. 641
Hospitals in the Seventeenth, Eighteenth, and Nineteenth Centuries	p. 642
The Modern Hospital and Health Systems	p. 645
Classification of Hospitals	p. 646
Hospital Organization and Management	p. 651
Services Provided by Hospitals	p. 651
Change in the Hospital Industry	p. 651
The Major Changes and Their Implications	p. 652
What is an Organization?	p. 652
The Structure of the Hospital Organization	p. 653
The Bureaucratic Principles	p. 653
A Team of Three	p. 655
Governance	p. 655
The Trustee in an Organized Delivery System	p. 657
The CEO and the Administration	p. 658
Conclusion	p. 660
Patient Access Services: Into, Through, and Out of the Healthcare Process	p. 663
Areas of Responsibilities	p. 663
Departmental Functions	p. 665
Management Responsibilities	p. 673
Staff Responsibilities	p. 674
Emerging Technologies and Trends	p. 674
Conclusion	p. 675
Laboratories	p. 677
Service Levels	p. 678
Organization	p. 679
Staffing	p. 682
Information Systems	p. 688
Physical Plant and Equipment	p. 691
Laboratory Regulation/Compliance	p. 697
Strategic Planning	p. 699
Conclusion	p. 701
Sample of Test Type by Section	p. 703
Job Analysis Checklist: Medical Director	p. 704
Pharmacy	p. 707
Pharmacy Practice	p. 708
Pharmacy Management and Leadership	p. 710
Pharmacist Training and Education	p. 713
Pharmacy Technician Training and Education	p. 714
Pharmacy Information Systems	p. 714
Inpatient Pharmacy Services	p. 717
Inpatient Drug Distribution and Management	p. 719
Sterile Products Preparation	p. 722
Pharmacy Service Location	p. 725
Ambulatory Care and Outpatient Pharmacy Systems	p. 726
Patient Care Committees	p. 728
Financial Management	p. 730
Cost and Productivity Management	p. 730
Managing Drug Costs	p. 732
Conclusion	p. 735
Material and Resource Management	p. 737
Supply Chain	p. 738
Managing the Core Functions	p. 743
Materials Management in Alternate Site Locations	p. 758
Future Trends in Materials Management and Purchasing	p. 759
Bidding Instructions (Simple Format)	p. 761
Bidding Instructions (Complex Format)	p. 764
Designing and Implementing a Hospital Compliance Program	p. 773
The Value of an Effective Compliance Program	p. 774
Basic Elements of an Effective Compliance Program	p. 780
The Initial Needs Assessment/Compliance Review	p. 784
Integrating the Compliance Program	p. 784
HIPAA Privacy Rule Compliance	p. 792
Investigations and Corrective Action	p. 801
Disability Access Compliance	p. 803
Conclusion	p. 811
Quality Assurance and Improvement	p. 815
Contributors to Quality Health Care	p. 815
Organizations	p. 818
Methods	p. 825
Tools	p. 833
Conclusion	p. 840
Physician Practice: Organization and Operation	p. 843
Forms of Physician Practice	p. 843
Managed Care Delivery Systems and Forms of Physician Organizations	p. 850
Operational Aspects of Physician Practice	p. 853
The Future	p. 869
Implementing a Physician Practice Compliance Program	p. 871
The Compliance Plan within the Context of a Physician Practice	p. 872
The Elements of Compliance Plans and Programs	p. 881
A Planning and Implementation Work Plan	p. 897
Sample Compliance Plan and Program Work Plan	p. 898
Index	p. 915
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