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Introduction to US Health Care

• HS230 Health Care Administration

• Unit 2: Health Care Professionals

• Chapter 2 & Chapter 5

• Kaplan University

• Kathy L. Lantz, MHS, MBA

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Introduction to US Health Care

Chapter 2

Boards and Governance

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Core Responsibilities

1. Determine mission, vision, and values

2. Ensure a high level of management performance

3. Ensure the quality and safety of patent care

4. Ensure the organization’s financial health

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Mission Statement

• Purpose• Characteristics and values of

organization• Identify target market• Organizational philosophy and values

Serves all stakeholders!

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Ensuring Management Performance

Board CEO•Recruit and select CEO•Specify CEO performance expectations•Assess CEO performance•Adjust CEO compensation•If needed, terminate CEO

•CEO is responsible to institutes policies and strategies to carry out mission

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Ensuring Quality of Care

• Appoint member of the medical staff• Ensure quality, utilization, and risk

measurement systems are in place• Assess the quality and safety of care

for patients employees and services delivers

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Ensuring Financial Health

Budget aligned with plans?

Monitor outcomes vs. budget

Financial controls

Protect Assets

Financial objectives

Approve budget

Financial Health

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• Board Structure• Board Composition• Board Infrastructure

Board of Directors

Key Components:

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Standing Committees

• Executive• Finance• Planning or

strategy• Quality

Credentialing

• Nominating• Audit• Compensation• Quality /

Performance / Process Improvement

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Financial Status of Hospitals

•More complex health systems•Rising cost of health care•Changing regulations regarding board composition & accounting

In 2003, nearly 1/3 hospitals lost money overall… (AHA)

Sarbanes-Oxley Act

• Passed in 2002• Intended to protect investors by

improving the accuracy and reliability of financial statement and establishing harsher penalties for those who violate the law.

• Key components include, mandates regarding board composition and financial and auditing responsibilities.

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• Liability of Board Members– Health Care Quality

Improvement Act of 1986 (HCQIA)

• Reporting and Disclosure of Accounting Information

• Conflict of Interest• Board Performance

Current Issues Facing Boards

Health Care Quality Improvement Act of 1986

• HCQIA • Act established primarily to

protect individuals and hospitals conducting medical peer review against legal action by physicians whose practice privileges were revoked.

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Critical Thinking Application

Why is a mission statement important for the effective operation of governing board?

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Mission Statement• The purpose of the organization is determined

by mission, vision and value statements.

• The mission statement may include:1) the purpose of the organization2) characteristics and values of the organization 3) identification of target customers and markets 4) organizational philosophy and values5) types of services delivered

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Chapter 2: Vocabulary Quiz

• Board of directors• Chief executive officer (CEO)• Compensation committee • Credentialing committee• Executive committee• Finance committee• Governing board• Health Care Quality Improvement Act of 1986• Mission statement• Sarbanes-Oxley Act 

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Introduction to US Health Care

Chapter 5

The Health Care Workforce

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Health Care Industry: Statistics

• 12 million working in health care

• By 2010, employment is expected to increase 25%

• Between 2000-2010, health care will account for 13% of new jobs created

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Health Care Workers

43%

15%

15%

6%

21%Hospitals

Nursing andPersonal Care

Physician Officesand Clinics

Dentist Offices andClinics

Other

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Health Care Occupations

• Professional– Physicians, nurses,

pharmacists…• Service Worker

– Patient assistants, aids…• Administrative Personnel

– Support staff, managers…

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Physicians

Doctors of Medicine (MDs)

Doctors of Osteopathy

(Dos)•Treating disease •Emphasis on

neuromusculoskeletal system•Preventative care•Holistic care

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Physicians

Generalists

• Family Doctors• Comprehensive

Healthcare• Referral to

Specialists

Specialists

• Residency Program

• Medical Specialty Exam

• Higher Income

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Becoming a Physician

• Undergraduate• Medical School

– Preclinical– Clinical

• Residency

Board Certified

• Subspecialty

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Ensuring Financial Health

Registered Nurse (RNs)

Graduate Trained

Administer Medications

Supervise Personnel

Assist Physicians

Licensed Practical Nurses

(LPNs)Take Vital Signs

Keep Records

Assist in Patient Hygiene

Critical Thinking Application

Discuss the profile of nurses in the U.S.

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Nursing Profile• There are many levels of nursing based on

education level. • There are 2.7 million registered nurses. • In 2000, there were 816 nurses per 100,000

people. • The average age of a nurse is 45. • 94% of nurses are female and married. • 86% are white. • 59% of nurses are employed in hospitals.

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Health Care Professionals

• Dentists• Optometrists• Chiropractors• Podiatrists• Pharmacists

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Physical Therapists

• Musculoskeletal focus• Restore functioning

and improve mobility• Non-drug, non-surgical

therapy• Graduate training

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Physician Assistants (PAs)

• Conduct histories and exams

• Interpret tests• Make diagnoses• Perform procedures• Supervised by physician

Chapter 5: Vocabulary Quiz

• Allopathic physicians (M.D.s.)• Chiropractors• Hospitalist• Nurse midwife• Nurse practitioner• Optometrists• Osteopathic physicians (D.O.s)• Pharmacists• Physician assistants (P.A.s) .• Podiatrists• Registered nurse (R.N)•  

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Introduction to US Health Care

• HS230 Health Care Administration

• Unit 2: Health Care Professionals

• Chapter 2 & Chapter 5

• Kaplan University

• Kathy L. Lantz, MHS, MBA