Administrative Health Care Annotated Bibliography

Administrative Health Care Annotated Bibliography

HCS 465

Administrative Health Care Annotated Bibliography

An annotated bibliography provides the reader with information on each source included in the bibliography. As sources are composed, a brief description of the source follows detailing the importance of the source, the relevance, and the quality of the source. In health care, the administrator handles a variety of tasks each day. During a regular day, the health care administrator will handle problems, and solve issues. In creating an annotated bibliography for a health care administrative issue, I choose the issue administrators face with budget constraints at a health care facility.

The following annotated bibliography relates to care coordination or care continuum. Although, there are many issues that are dealt with in any health care organization, administrators worry about clinical, operational, and administrative issues. Administrators are trying to find a way to decrease waste and increase efficiency that will benefit the organization and patients.

Annotated Bibliography

Bentley, T. G. K., Effros, R., & Palar, K. (2008, December). Waste in the U.S. Health Care System: A Conceptual Frame. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690367/

This article focuses on waste reductions, wasteful spending, and what approaches can be taken to lower healthcare costs. The two types of waste are productive inefficiencies and allocative inefficiencies, which produces excess waste in production or products. Administrators are responsible for staffing, patient volume, supplies, and insurance contracts, premiums and claims that are directly linked to healthcare costs. It is the role of the administrator to focus on goals for the entire organization to ensure that spending is resourceful rather than wasteful.

The productive inefficiencies and allocative efficiencies were researched and the organizations determination was to be able to split up the waste into three categories, which are administrative, clinical, and operations. The waste was determined and placed into a category that could be furthered researched. By decreasing the number of useful resources, the organization would then implement a Health Information Technology, which could increase efficiency and decrease the number of lost supplies, medical errors and mortalities. The administrators linked clinical waste with operational waste, if there were lost orders, medical errors then there may be repeat studies or procedures that would need to be done if they were unable to find the previous results. With a more efficient system, less resources this decreases the cost and mistakes made. This article relates to our final project because it discusses the budget constraints faced by administrative health care workers.

Eichler , H.-G., Kong, S. X., Gerth, W. C., Mavros, P., & Jönsson, B. (2004). Use of Cost‐Effectiveness Analysis in Health‐Care Resource Allocation Decision‐Making: How Are Cost‐Effectiveness Thresholds Expected to Emerge? Journal of Theoretical Social Psychology, 518-528.

Health care administrators are tasked with finding cost-effective ways to carry out daily functions of the organization. Eichler, Kong, Gerth, Mavros, and Jönsson (2004) believe that taking a cost-effective analysis approach to the health care system will allow better and more efficient allocation of health resources. Effective decision-making involving costs and budgeting requires health care administrators to consider the organization’s funding, total assets and liabilities, and shareholders. The task of evaluating cost-effective ways to save money and still guarantee quality services and care lies in the hands of the health administrator.

In relation to budget contraints faced by health care administrators, this article addresses ways that health care administrators can carry out daily tasks and decision-making through a cost-effective approach. Paying attention to budgeting and researching decisions that affect the budget may lead to savings for the health care facility.

Jiwani, A., Himmelstein, D., Woolhandler, S., & Kahn, J. G. (2014). Billing and insurance-related administrative costs in United States’ health care: synthesis of micro-costing evidence.  Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25540104

Health care administrators focus on quality care for patients and ensuring that the employees are being taken care of. Administrator’s responsibility focuses on billing and insurance-related issues and the increased health care costs in the United States. Health care cost rises if the facility is understaffed or overstaffed. This article focuses on studies and surveys used to find the amount of time employees spend on certain tasks. There is added amount to the BIR because of insurances, hospitals, physicians, supplies, and other health services. Billing and insurance-related issues have to do with overhead, technology, insurance verification, and coding and because of these issues, it has cost billions of dollars and has contributed to the rise in cost. This study is focused on implementing a revised and simpler financial system to lower the burden of health care costs. Billing and insurance-related issues have to do with overhead, technology, insurance verification, and coding and because of these issues, it has cost billions of dollars and has contributed to the rise in cost.

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System: Medicare Fraud & Abuse: Prevention, Detection, and Reporting

Retrieved from https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/fraud_and_abuse.pdf

Health Care fraud waste and abuse is a large part of the costs associated with the nation’s health care expense; there is currently no way to measure or determine the exact cost, but the estimates are in the billions. Medicare abuse can be billing for medical services that were delivered but not necessary, and fraud can be charging for services that were not performed, either of these two activities has a large impact on the patients who need services and the costs that are incurred. The “anti-Kickback Statue” prohibits physicians and medical suppliers from receiving monetary or any other type of compensation for unnecessary referrals. The Physician Self-Referral Law (Stark Law), which penalizes physician’s for referring their patients to entities they have any ownership/investment interest in, for specific designated services.

Government regulatory agencies created a partnership with Medicare to help monitor, identify, and maintain the integrity of not just Medicare but the entire health care system. The agencies are Health Care Fraud Prevention Partnership (HFPP) and Centers for Medicare & Medicaid (CMS), amongst many other accredited agencies that prevent, detect, and investigate fraudulent health care activities. The health care administrator works with the billing department to assure rules, regulations, and laws are followed in regards to honest billing procedures.

Vermeulen, I., Lameris, H., & Bohte, S. (2009). Adaptive Resource Allocation for Efficient Patient Scheduling. Artificial Intelligence in Medicine, 46(1), 67-80, https://doi.org/10.1016/j.artmed.2008.07.019. Retrieved from University of Phoenix Library http://www.sciencedirect.com.contentproxy.phoenix.edu/science/article/pii/S0933365708001085 web page; accessed July 2017.

This article discusses the efficiency of patient scheduling on expensive resources through a variety of methods, such as simulated experiments. The hypothesis of this article is whether the capacity of allocation improves performance of patient scheduling and the efficient utilization of resource capacity. The methods presented consist of resource calendars and length of time a patient spends with a physician. Through utilization of such methods, the results prove the hypothesis is correct and the evidence is supported by statistical data.

This is a peer-reviewed article reviewed by experts prior to publishing. Scheduling techniques that affect a health care organization’s bottom line require the attention of the health care administrator. Scheduling is a health care related issue that has the potential to affect the flow of cash to a health care organization.