Health Service Department Implications
-Please Note Class 1 and 2 are seperate courses and should be answered accordingly.
Class 1/ Classmate #1- Please respond to this discussion in atleast 475 words with 2 scholarly source and 1 biblical citation in APA format
In a health services department, the cost center is responsible for only the costs which take place in a specific department while the profit center is accountable for the revenues and costs of a department division (Harrington, 2016, pp. 14-15). These can be either centralized or decentralized. In centralization, the staff are one group that is independent of other groups. This allows for the group to have set standards, reporting, tools, and processes, flexibility to move within domains, more staff with different expertise, and set deadlines when things need to be done (Staheli, 2019). On the other hand, decentralization within health service business staff work for different groups or departments which does not require competition from others in order better focus on patients and resources (Staheli, 2019). However, a decentralized approach requires staff to be highly knowledgeable with experience in order to work with management who needs to know a deadline of completion as well as awareness of the specialized processes, tools, and reports that the analyst uses (Staheli, 2019).
How the health service department can stick to its historic mission of serving those without insurance and/or those that are historically underserved can focus on keeping healthcare access to those who need it most and finding health plans that those individuals can afford. The health care systems must confront any barriers and provide fairness to all regardless of ethnicity, socioeconomic status, gender, or geographical location to promote growth in the community as well as avoiding waste, especially of equipment, resources, concepts, and energy (Burns, McCullough, Wholey, Kruse, Kralovec, & Muller, 2015). Also, the “need for good communication and partnership with physicians was by far the most commonly voiced priority for patient care… communication and partnership with physicians reflected patients’ desire to understand their illness, to share in the decision making of their care management, and to feel they have the attention of their physicians when they have questions and concerns” (Mead, Andres, & Regenstein, 2014). To become an affordable care organization (ACO), a health services department must become more patient-centered, coordinate quality management, align in the community culture to promote health and wellness, and create a greater systems perspective in order to improve workflows and allow for patients to come to the organization and receive the care they need (Burns et al., 2015).
For public health professionals who are not permitted to bill or have reimbursable codes, they will face criminal charges that include termination of employment, up to 10 years of imprisonment, and fines from $2,000 to $10,000 as laid out in the The Health Insurance Portability and Accountability Act (HIPAA) (Prophet). HIPAA was passed in 1997 to identify and take down healthcare fraud and abuse as well as individuals who purposely and decisively “attempt to execute a scheme to defraud any healthcare benefit program or to obtain, by means of false or fraudulent pretense, money or property owned by, or under the custody of, a healthcare benefit program” (Prophet). 1 Chronicles 29:17 states “I know, my God, that you test the heart and are pleased with integrity. All these things I have given willingly and with honest intent. And now I have seen with joy how willingly your people who are here have given to you.” It is vital only for the Health Information Management department of a hospital or ambulatory practice and certified coders and billers to handle any billing and coding for reimbursement and payment from insurance companies (Harrington, 2016, p. 13).
Proverbs 16:3 tells us “Commit to the Lord whatever you do, and he will establish your plans.” When moving to a cost center to a profit center, a health services department will focus on reducing costs by streamlining processes, working smarter in regards to daily tasks, meeting deadlines, and negotiating with certain medical suppliers for the best price equipment and medications that will not create overstock and waste. Also, a department can improve its customer service, quality of care, ease of scheduling, and offering of services. For instance, where I currently work, the radiology department is moving the thyroid ultrasound department (where most thyroid biopsies are done) to another facility close by in order to promote more complex biopsies at the primary radiology office as well as decrease the risk of infection (we have inpatient procedures, some on isolation precautions) to patients needing thyroid biopsies and having long wait times. This has improved scheduling for patients because now they are more openings in our primary biopsy suite and it gives the doctors more time to focus on complex procedures. We have new biopsy trays that include everything we need for most biopsies and, if something else is needed, it is dropped on the tray. Through streamlined processes, timely scheduling, and new workflows, the radiology department is moving more efficiently and is bringing in more business, which is allowing another step closer to becoming a profit center.
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Burns, L. R., McCullough, J. S., Wholey, D. R., Kruse, G., Kralovec, P., & Muller, R. (2015). Is the system really the solution? operating costs in hospital systems. Medical Care Research and Review, 72(3), 247-272. doi:10.1177/1077558715583789
Harrington, M. K. (2016). Health care finance and the mechanics of insurance and reimbursement. Burlington, MA: Jones & Bartlett Learning.
Mead, H., Andres, E., & Regenstein, M. (2014). Underserved patients’ perspectives on patient-centered primary care: Does the patient-centered medical home model meet their needs? Medical Care Research and Review, 71(1), 61-84. doi:10.1177/1077558713509890
Prophet, S. (n.d.). Fraud and Abuse Implications for the HIM Professional. Retrieved January 15, 2019, from http://library.ahima.org/doc?oid=57611#.XD6Ub1xKiU…
Staheli, R. (2019, January 02). Healthcare Reporting: Centralized vs. Decentralized. Retrieved January 15, 2019, from https://www.healthcatalyst.com/healthcare-reportin..
CLASS #1/ CLASSMATE #2- Please respond to this discussion in atleast 475 words with 2 scholarly source and 1 biblical citation in APA format
The Difference between a Cost and a Profit Center
In any organization, you have parts of the business that generate profit, and those that result in costs and expenses. These are called profit centers and cost centers. Profit centers will make large profits steadily while cost centers do not directly create profits but are critical to a firm’s long-term profitability and success (Difference Between, 2013).
Departments or within an organization are essential to the operation of the organization and include offices such as customer service, research and development, and marketing (Difference Between, 2013). These types of offices or departments do not generate profits for the organization but are used to maintain profitability in the organization. The other portion of the organization is the profit side or the profit centers. These offices, divisions, or departments in the organization are responsible for generating profits (Difference Between, 2013). The profits generated from the profit centers are used to fund the different cost centers within the organization.
Decentralization versus Centralization within the Health Service Business
Decentralization can be described as a wide variety of power transfer arrangements and accountability systems (World Bank, n.d.). Healthcare decentralization has become appealing too many because of its several advantages. These include cost containment from moving to streamlined target programs, greater community financing and involvement of local communities, and greater integration of activities of different public and private agencies (World Bank, n.d.).
Centralized healthcare reduces the cost of healthcare for everyone. This method can make healthcare more affordable including the government that subsidizes most of the healthcare under a centralized health care plan (HRF, 2015). Centralized healthcare can also mean connected care between your physicians. This will, in turn, offer more time to be spent on the patient, rather then time spent review medical diagnosis and treatment reviews. Within centralized health care organizations, health care is equal across all economic groups regardless of their social status and finance (HRF, 2015).
How the health service department can stick to its historic mission of serving those without insurance and/or those that are historically underserved.
Those individuals that are not insured and those that are underserved should still be able to receive medical care under certain circumstances. These costs are picked up by different parties such as practitioners and different institutions, the federal government and other donations made to organizations (IOM, 2003). Continuing to allow patients that are uninsured or underserved to utilize the hospitals will allow for healthier outcomes in the community. Emergency departments typically serve as primary care providers for persons that are uninsured but also account for extensive wait times in the ED (Doyle, 2013). One way that the healthcare departments could better serve the underserved is to hire more primary care physicians in local or rural areas. The biggest reason for an overcrowded emergency department for non-emergent cases is due to the limited, or no access to primary care physicians (Doyle, 2013). Lastly, many hospitals have begun establishing charitable service programs that provide uninsured or underserved people with medical homes or different healthcare options to keep them from crowding the emergency departments (Doyle, 2013).
The implications of having public health professionals that are not permitted to bill or have reimbursable codes.
There have been many instances where physicians or healthcare professionals have billed patients for incorrect procedures, or have overcharged patients for services performed. The Healthcare fraud statute makes it a criminal offense if knowingly and willingly execute a scheme to defraud a health care benefit program (CMS, 2015). The false claims act also establishes liability for offenses related to certain acts. Individuals and entities that make false claims are subject to civil penalties up to $11,000 for each false claim (CMS, 2015). Furthermore, Persons who knowingly make a false claim may be subject to criminal fines up to $250,000 or imprisonment up to 5 years (CMS, 2015).
Speaking of the uninsured vs insured, cost centers vs profit centers and other instances such as providers/physicians charging patients for incorrect procedures lead me to think about the disservice we do to our patients if faced with having to figure out what to do about our shortfalls and healthcare providers. Once we catch mistakes, or if we make mistakes we must do everything we can to right that wrong and make sure patients do not have to suffer or deal with the implications that come from the error, or mistake. The bible says “And whatever you do, in word or deed, do everything in the name of the Lord Jesus, giving thanks to God the Father through him (ESV)” Colossians 1:20. We are human and we make mistakes, owning up to it, and righting our wrongs is where we will do justice not only for ourselves in the eyes of the lord but for our patients as well.
CMS . (2015, September). Retrieved from Laws against health care fraud resource guide: https://www.cms.gov/Medicare-Medicaid-Coordination…
Difference Between. (2013, May 1). Retrieved from Difference between cost center and profit center: http://www.differencebetween.com/difference-betwee…
Doyle, D. (2013, March 8). Physician Practice. Retrieved from Emergency rooms continue to serve as patients’ primary care provider: http://www.physicianspractice.com/blog/emergency-r…
HRF. (2015, July 15). Retrieved from Pros and cons of centralized healthcare: https://healthresearchfunding.org/6-pros-and-cons-…
Institute of Medicine (2003). Hidden costs, values Lost: insurance in America. Spending on health care for uninsured americans: how much, and who pays? https://www.ncbi.nlm.nih.gov/books/NBK221653/
Each reply should be at least 200–250 words and should adhere to *AMA writing guidelines
Cell phone use while driving continues to be a problem in the United States. Even though most states have banned the use of cell phones while driving, many individuals continue to use their cell phone while driving to make calls and send out text messages. “There is a substantial body of literature that is comprised of experimental, epidemiologic, and naturalistic studies, which show cell phone use while driving negatively affects driving ability as it likely interferes with a driver’s visual, manual, and cognitive function.”1 Even though drivers have been told about the negative effects of driving and using a cell phone at the same time, many individuals continue to use their cell phones while driving.
Primary strategies that can be utilized to prevent the use of cell phones while driving may include the promotion of educational programs which aim to show statistics on the number of accidents that occur due to cell phone usage while driving. In 2015, it was estimated by the World Health Organization that 1.2 million people die worldwide annually due to car accidents caused by using a cell phone while driving.2 Showing statistics that prove that driving and using a cell phone at the same time may help to prove that doing so is a bad decision. In North Carolina where I live, it is still legal to talk on a cell phone while driving but it is illegal to text and drive. I do feel that both activities need to be illegal in order to improve driving habits and reduce the number of accidents caused by distracted driving.
Secondary strategies that may be used to prevent the use of cell phone use while driving may include the use of Bluetooth applications which enable a driver to make a call without having to hold a phone to their ears. Most all new cars come with this feature so drivers can make hands free calls. Another secondary strategy that one may use to reduce the use of cell phone use while driving is by enrolling in an auto insurance program that offers incentives for using applications that track driving behavior. For example, Allstate uses a phone application called Arity. This app senses whether your phone is being moved, if it’s unlocked, or if apps are in use while you are driving. Allstate then gives incentives for drivers that do not use their cell phones while driving.
A tertiary strategy that may be implemented to prevent the use of a cell phone while driving may be enabling a phone setting that automatically disables the phone while driving such as a “Driver Mode”. Many of the top cell phone manufacturers are now adding a feature that turns your cell phone off while driving and alerts those who try to contact you that you are driving at the moment.
The overall goal of implementing strategies such as these listed is to improve driver safety and awareness. Many senseless accidents could then be avoided, insurance rates could go down, and the general public could begin to feel safer on the road.
1. Rudisill TM, Zhu M. Hand-held cell phone use while driving legislation and observed driver behavior among population sub-groups in the United States. BMC public health. 2017;17.437.
2. Oviedo-Trespalacios O, King M., Hague M, Washington S. Risk factors of mobile phone use while driving in Queensland: Prevalence, attitudes, crash risk perception, and task-management strategies. PLoS One. 2017;12:e0183361.
- Foodborne Illness and Causes: Foodborne illness is a serious public health problem. CDC estimates that each year, one in six Americans (48 million) will experience a foodborne illness, 128,000 are hospitalized, and 3,000 die as a result.1 Most foodborne illnesses, hospitalizations, and deaths are caused by one of eight common pathogens: Norovirus, Salmonella, Clostridium, Campylobacter, Staphylococcus aureus, Toxoplasma gondii, Listeria, and E.coli.1,2 Anyone can get a foodborne illness, however, infants, pregnant women, older adults, and those with weak immune systems are more likely to develop foodborne illnesses than others.1,2
Meat: Animals carry bacteria such as Salmonella, E. coli or Clostridium perfringens on their skin or hides and in their intestines. If great care is not taken, any faecal matter on the hide can come into contact with the flesh.
Poultry: Where chicken or turkeys are eviscerated by the same machine or knife this can result in the transfer of bacteria such asCampylobacter and Salmonella from one infected bird to several others. Also their eggs can carry bacteria.
Vegetables: Raw vegetables can carry bacteria such as Clostidium perfringens from the soil that may be contaminated by spreading slurry or farmyard manure. Fruit and vegetables may also be subjected to chemical contamination -pesticides and herbicides.
Shellfish: Shellfish such as mussles, oysters, clams, scallops are filter feeders, therefore bacteria and viruses can accumulate in the flesh. It is essential that shellfish are reared in clean waters and handled carefully.
II. Primary Prevention:
A. Food safety Inspection:
a. FSIS of USDA perform food safety inspection of meat, poultry, and egg products and operates public education and outreach program such as Meat and Poultry Hotline and web-based Ask Karen.3
b. Health agencies train and certify food management practices by FDA Model Food Code to farmers, grocery stores, and restaurants.4
B. Public Health Education:
a. Health care agencies and schools educate personal hygiene and food safety practices: clean hands and surgaces, no cross-contaminate, cook to the right temperature, and refrigerate promptly.1,2,4
b. Safe food and water; washing hands, cutting boars, utensils, and countertops; rinsing fresh fruits and vegetables under running water; keeping raw meat, poultry, and seafood separate from other foods.; cooking to internal termperature, 145oF for whole meat and 1600F for ground meats, and 1650F for all poultry.; Keep refrigerator below 400F; do not prepare food for others if having diarrhea or vomiting.1,2,4
III. Secondary Prevention:
A. Healthcare Provider: Common symptoms of foodborne illnesses include vomiting, diarrhea, fever, abdominal cramping, headach, and dehydration. Dagnosis can be made through stool culture or advanced laboratory testing.5 However, these results should not delay empiric treatment if a foodborne illness is suspected. Empiric treatment should focus on symptom management, rehydration if a patient is dehydrated, and antibiotic therapy.5 Every outbreak begins with an index pattient who may not be severely ill. A physician should be able to make an early and expeditious diagnosis and ask appropriate question to recognize the etiology of a goodborne disease early. Physicians also should talk food safety to high-risk patients.5 Foodborne illnesses should be reported to local and state health agencies.5
B. Local health agencies: they learn about foodborne illness outbreaks through reports of individual cases from health care providers and laboratories. They inspect and identify outbreaks.6
C. State health departments: typically receive and analyze routine disease surveillance reports, coordinate surveillance among the local health departments, and report cases of foodborne illness to the CDC to work with CDC, federal food safety agency, and the State department of agriculture.6
D. CDC has a program called FDOSS, a part of the National Outbreak Reporting System (NORS) to collect and report data about foodborne disease outbreaks: date, location, number of people affected, food or drink implicated, setting where the food or drink was prepared and eaten, and pathogen.6 Once an outbreak has occured, prevention strategies should focus on educating the public through the news media and correcting the underlying cause, such as through food product recalls.6
IV. Tertiary Prevention: If food and health employees are jaundiced for more than 7 days, should not return to work until after they get clearance from the local health department.7 Workers can return to work 24 hours after any diarrhea and vomiting symptoms have ended.7
V. New Challenges to food safety:
A. More changes in our food production and supply and more imported foods, which make the inspection harder. For example, USDA audit is not equivalent to the audit of Chinese-processed chicken in China, but it chicken may be used in school meals.8
B. More changes in the environment leading to food contamination is detected.1,8 Environmental changes such as high temperature and hudmidity could increase mycotoxin growth, which is toxigenic mold growing on crops and being transferred to humans and animals, causing cancers. Climate change and higher water temperature exacerbate water pollution including sediments, nutrients, and dissolved organic carbon.
C. More new and emerging bacteria, toxins, and antibiotic resistance emerge.8
- Center for Disease Control and Prevention (CDC). Food Safety. https://www.cdc.gov/foodsafety/index.html.
- CDC. Foodborne Outbreaks. https://www.cdc.gov/foodsafety/outbreaks/index.html
- USDA. About FSIS.https://www.fsis.usda.gov/wps/portal/informational/aboutfsis/history/!ut/p/a1/04_Sj9CPykssy0xPLMnMz0vMAfGjzOINAg3MDC2dDbz8LQ3dDDz9wgL9vZ2dDdz9TYAKIkEKcABHA0L6vYiwwKjI19k3XT-qILEkQzczLy1fPyIjs7gkv6hSP1w_Cq8B7qYwBbhdWJAbUeWTFuwJAKM7ymo!/?1dmy¤t=true&urile=wcm%3apath%3a%2FFSIS-Content%2Finternet%2Finformational%2Fabout-fsis.
- The Center for Foodborne Illness Research & Prevention. Prevention. https://www.foodborneillness.org/prevention.html.
- Switaj TL, Winter KJ, Christensen SR. Diagnosis and Management of Foodborne Illness. American Family Physician. 2015, Sept 1;92 (5):358-365.
- CDC. Foodborne Disease Outbreak Surveillance System (FDOSS). https://www.cdc.gov/fdoss/index.html.
- Food & Drug Administration (FDA). Employee Health and Personal Hygiene Handbook.https://www.fda.gov/downloads/Food/GuidanceRegulation/RetailFoodProtection//UCM194575.pdf.
- Stop Foodborne Illness. The Effects of Climate Change on Foodborne illness. https://stopfoodborneillness.org/issue/chinese-chicken-processing-importation/. accessed Jan. 2019.