Healthcare Organization Analysis
Value-based health care is frequently mistaken for quality, a nebulous idea that suggests numerous positive attributes, while health care often emphasizes inputs and adherence to processes. The emphasis of value-based health care is on improved health outcomes, aligning the objectives of the organization with those of its patients. Value-based health care serves as a means to attain the ambitious goals of the Institute for Healthcare Improvement’s “triple aim,” which include enhancing the patient’s care experience, improving the health of populations, and decreasing the per capita cost of health care (Teisberg et al., 2020). This paper examines and compares the payment model of two healthcare organizations and compares them with the principles of value-based care.
Healthcare Organization Identification
I have chosen Doctors Medical Center of Modesto, situated at 1441 Florida Avenue, Modesto, CA 95350, as my healthcare organization of interest based on the information provided by AHD. This particular hospital has captured my attention due to its prominence and the crucial role it plays within our community. Doctors Medical Center of Modesto holds a significant place in my heart as it is where my grandmother received exceptional care during her prolonged battle with illness. The compassionate and dedicated medical staff, along with the state-of-the-art facilities, made a lasting impact on our family. We were particularly grateful for the attentive nurses who patiently addressed our concerns, the oncology team who tailored treatment plans, and the overall comforting environment that helped alleviate our anxiety. Healthcare Organization Analysis
PLACE YOUR ORDER HERE NOW
Doctors Medical Center of Modesto has been classified as a Short-Term Acute Care facility by the AHD, offering a variety of medical services such as emergency care, surgery, diagnostic imaging, and inpatient treatment as part of its acute care hospital services. The hospital also houses specialized departments like cardiology, oncology, and obstetrics to cater to the diverse needs of its patients, ensuring comprehensive healthcare services are provided. The AHD has labeled the type of control for Doctors Medical Center of Modesto as Proprietary, denoting that it is privately owned and operated. This form of control has a significant impact on the hospital’s decision-making processes, financial management, and overall operational strategies, shaping its focus on efficiency, revenue generation, and competitive positioning within the healthcare market.
According to the information provided on the Care Compare website, Doctors Medical Center of Modesto, located in Modesto, CA, has been recognized as excelling in three adult procedures and conditions, earning a high-performing rating. This medical facility is categorized as a general medical and surgical center, catering to a wide range of healthcare needs in the community. Regrettably, the Overall Star Rating for Doctors Medical Center of Modesto stands at one star, with specific ratings for mortality at 7 out of 7, safety of care at 7 out of 8, readmission at 9 out of 11, patient experience at 8 out of 8, and timely and effective care at 9 out of 12. Healthgrades is a reliable and trustworthy platform that offers valuable data on healthcare organizations. It provides a wide range of information about hospitals, physicians, and other healthcare providers. This includes ratings, reviews, and detailed profiles that are based on both patient experiences and clinical outcomes (Healthgrades, n.d.). In terms of the Healthgrades rating for Doctors Medical Center Modesto, the patient experience rating stands at 57%, which is 7% lower than the national average. This rating reflects that the hospital’s performance in different areas of patient experience differs from the national averages. Although the communication with nurses and the provision of discharge information is in line with the national norms, the hospital falls slightly behind in terms of staff responsiveness, communication about medicines, and understanding of care transitions. It is worth noting that the hospital faces significant challenges in maintaining a quiet environment around patient rooms at night and ensuring cleanliness, both of which are below the national standards. These findings highlight the importance of focusing on improving staff responsiveness, communication protocols, and environmental quality to enhance overall patient satisfaction and the quality of care provided within the hospital. Healthcare Organization Analysis
Organizational Ethics and the Role of Nurse
Doctors Medical Center of Modesto is a privately owned acute care hospital that operates under proprietary control. This means that the organization is profit-driven, which affects its decision-making, financial management, and operational strategies. However, despite being profit-driven, the hospital is committed to providing high-quality, patient-centered care, demonstrating its ethical practices. In addition, the hospital practices responsible resource allocation to ensure effective financial stewardship while balancing financial sustainability with patient outcomes. Doctors Medical Center upholds its ethical obligations by effectively distributing resources to ensure high-quality care. The hospital diligently manages its finances, directing funds toward patient well-being, staff development, and essential medical equipment. In line with its commitment to fairness and inclusivity, Doctors Medical Center embraces diversity and treats all employees with equality. Regardless of gender, ethnicity, or race, the hospital fosters equal opportunities for professional growth, cultivates a supportive workplace atmosphere, and values the input of every staff member in the decision-making process.
Nurses promote responsible resource use in value-based care through key functions such as effective care coordination, patient education, and advocating for cost-effective interventions (Demiris et al., 2020). Doctors Medical Center of Modesto could implement telehealth solutions and foster interprofessional collaboration among clinicians, administrators, and support staff to enhance value-based care delivery.
Organizational Comparison
Memorial Medical Center, situated in the same area as Doctors Medical Center in Modesto, is an additional hospital that offers acute care services. The importance of healthcare extends beyond simply reducing costs without reason. It encompasses a collaborative effort involving various professionals, providing a shared understanding among patients, clinicians, as well as financial and operational managers in the healthcare industry to enhance care equality and reduce gaps (Cacari Stone et al., 2021). According to Teisberg et al. (2020), the value of healthcare is determined by how much a patient’s health improves compared to the cost of achieving that improvement. According to the information obtained from the AHD and Care Compare websites, it seems that Memorial Medical Center is more focused on providing value-based healthcare in comparison to Doctors Medical Center. Memorial Medical Center shows a higher level of efficiency in terms of Medicare spending per beneficiary, with an MSPB ratio of 0.97, which is better than the national average. This indicates that they can deliver care more cost-effectively. Moreover, Memorial Medical Center demonstrates comparable or even superior outcomes for patients with heart attack, heart failure, hip/knee replacement, and pneumonia when compared to the national averages.
The primary difference between the two lies in their core objectives and how they function. MMC places a strong emphasis on providing healthcare services as a nonprofit hospital, whereas DMC goes beyond healthcare to engage in community-oriented initiatives. Memorial Medical Center, located in Modesto, CA, is a nonprofit hospital that operates under a tax-exempt 501(c)3 status, focusing on delivering healthcare services to the community. Since its establishment in November 1962, MMC has been dedicated to promoting community well-being through its healthcare services, which include general and rehabilitative services. MMC’s financial structure is designed to support its healthcare mission, relying on revenue sources such as patient fees, government reimbursements, and charitable donations. Philanthropic contributions play a crucial role in supplementing MMC’s operational funding, allowing the hospital to continue its commitment to providing quality healthcare services to the community.
Equitable Patient-Healthcare Organization Analysis Care
Doctors Medical Center may have an advantage when it comes to providing fair and patient-focused care, even though its performance is a mix of positives and negatives. Although the center’s Medicare spending per beneficiary is higher, suggesting the possibility of increased costs, it actually has lower payments for heart failure patients compared to the national average. Moreover, the payment information for heart attack and pneumonia patients is in line with the national averages. However, it is important to highlight that Doctors Medical Center has poorer outcomes for heart failure and pneumonia patients when compared to the national rates, which raises concerns about potential disparities in the quality of care provided.
Doctors Medical Center prioritizes patient-centered care, which means they always respect and respond to the unique preferences, needs, and values of each patient. In this approach, the goal is to ensure that the values and priorities of the patients guide every clinical decision. To achieve patient-centered care, it is crucial for healthcare organizations and professionals to actively listen and understand what matters most to their patients (Edgman-Levitan & Schoenbaum, 2021). To fully achieve this, an organization should be committed to adopting methods that help them gain a deeper understanding of their patients’ needs and preferences. An ideal organization believes in treating their patients as equal partners in their own healthcare journey. As a full-service healthcare facility, Doctors Medical Center is dedicated to providing high-quality medical care to the Stanislaus County community.
Sources to Inform Organizational Transformation
A crucial financial data source that can guide organizational change within healthcare institutions is the Healthcare Cost and Utilization Project (HCUP) database. Analyzing HCUP data enables healthcare organizations to spot trends, compare their performance, and make informed decisions to enhance efficiency and financial stability. Another valuable data source for assessing quality in healthcare is the Healthcare Effectiveness Data and Information Set (HEDIS) from the Agency for Healthcare Research and Quality (AHRQ). HEDIS is a widely recognized tool for measuring performance in critical areas of healthcare delivery, including preventive care, chronic disease management, and patient safety. By leveraging HEDIS data, healthcare organizations can evaluate their quality of care, pinpoint areas needing improvement, and implement evidence-based strategies to boost patient outcomes and satisfaction.
Conclusion
Doctors Medical Center of Modesto plays a crucial role in the community by offering essential healthcare services while ensuring a balance between quality care and financial stability. Its unique status influences how patient care is approached and organizational objectives are set. However, Memorial Medical Center seems to prioritize value-based healthcare more than Doctors Medical Center does. To improve the delivery of value-based care, Doctors Medical Center of Modesto could introduce telehealth options and encourage collaboration among healthcare professionals, administrators, and support staff. Healthcare Organization Analysis
References
Cacari Stone, L., Roary, M. C., Diana, A., & Grady, P. A. (2021). State health disparities research in Rural America: Gaps and future directions in an era of COVID-19. The Journal of Rural Health: Official Journal of the American Rural Health Association and the National Rural Health Care Association, 37(3), 460–466. https://doi.org/10.1111/jrh.12562
Demiris, G., Hodgson, N. A., Sefcik, J. S., Travers, J. L., McPhillips, M. V., & Naylor, M. D. (2020). High-value care for older adults with complex care needs: Leveraging nurses as innovators. Nursing Outlook, 68(1), 26–32. https://doi.org/10.1016/j.outlook.2019.06.019
Edgman-Levitan, S., & Schoenbaum, S. C. (2021). Patient-centered care: achieving higher quality by designing care through the patient’s eyes. Israel Journal of Health Policy Research, 10(1), 21. https://doi.org/10.1186/s13584-021-00459-9
Healthgrades. (n.d.). Doctors Medical Center Modesto. Healthgrades.com. Accessed April 14, 2024, from https://www.healthgrades.com/hospital-directory/california-ca-northern/doctors-medical-center-modesto-hgst92618d46050464
Lewis, S. (2022). Value-based healthcare: Is it the way forward? Future Healthcare Journal, 9(3), 211–215. https://doi.org/10.7861/fhj.2022-0099
Teisberg, E., Wallace, S., & O’Hara, S. (2020). Defining and implementing value-based health care: A strategic framework: A strategic framework. Academic Medicine: Journal of the Association of American Medical Colleges, 95(5), 682–685. https://doi.org/10.1097/ACM.0000000000003122 Healthcare Organization Analysis
