2.3.2 Single Service Line Hospitals

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En provenance du cours de University of Minnesota

Healthcare Delivery Providers

133 notes

University of Minnesota

Healthcare Delivery Providers

133 notes

Cours 2 sur 5 dans Specialization Healthcare Marketplace

Welcome to the exciting world of Healthcare Delivery Providers! This second course in the Healthcare Marketplace Specialization will help you understand the various providers of healthcare across the U.S. delivery continuum. We will explore the unique value proposition of the various providers- from hospitals and clinics to physicians to community based providers. We will dissect this important value chain using various lenses such as- site of care delivery, people who provide the care and payers who pay for care. You will also learn about the challenges facing these providers and the innovations they are creating in order to help transform this important industry. I will use readings such as a case study and videos to make this learning more experiential for you, so that you can see and feel the world of healthcare delivery. I will also explain the various acronyms and specialized terms used in healthcare, so that you become more proficient and familiar with the language. Given the fact that Healthcare is one of the largest industries in the U.S. and growing at an rapid pace, it is critical that current and future leaders understand the internal and external drivers that are shaping this industry. Current and future leaders will need to constantly innovate in order to sustain this industry into the future- by creating value for the end customer and the entire population, as well as increasing engagement of the humans who work within this industry. Get ready to take a deep dive into the complex ocean that is U.S. healthcare delivery- and make sure your oxygen tank is securely fastened!

À partir de la leçon

HOSPITALS: COMMUNITY & SPECIALTY

In this module I will lead you into the exciting and rapidly changing world of the Acute Care Hospitals. We will discuss the various types of hospitals in the US including community hospitals and specialized hospitals. We will also dissect the hospital as an organization through the lenses of org structure, humans, services and performance measurement. Throughout this module I will also cover the challenges facing the hospitals in the US and the innovations that they are leading through continuous quality improvement.

2.3.1 Critical Access Hospitals7:52

2.3.2 Single Service Line Hospitals7:56

2.3.3 Ambulatory Surgery Centers & Freestanding Emergency Departments9:20

Rencontrer les enseignants

Dr. Rahul Koranne
Faculty
Carlson School of Management, Department of Finance

This is the Healthcare Delivery Providers,

part of the Healthcare Marketplace Specialization.

This is Module 2.3.2, Single Service Line Hospitals.

The learning outcomes for this lecture are,

we will discuss hospitals that have either one or very few specialized service lines.

And also review their opportunities and challenges.

In patient psychiatry facilities.

So I do want you to note that there are some hospitals that only

provide a single type of service line, or very few service lines.

And I want to cover a few of those with you in this particular lecture.

So, we'll talk a little bit about pediatric hospitals, so

these are hospitals that focus on children and

taking care of very complicated children's needs.

Another type of hospital is the in-patient psychiatry facility or

the psychiatry hospitals that we talk will about.

Tertiary hospitals are those hospitals that provide very high end services.

So again, primary care is again, to primary services,

secondary is the community based hospitals doing a little bit more, and

then tertiary hospitals are those that do much more and act as referral centers.

And then finally, we will cover some emerging single specialty hospitals

focused on sub-specialty areas like heart and bones.

So let's start first with children's hospitals.

Obviously by, as the name indicates, these serve pediatric patients.

And focus on children with extreme medical complexity, and also vulnerable kids.

So a lot of other hospitals do have childbirth happen there.

They serve normal babies who have no medical problems.

But then, if a baby or a pediatric patient becomes sick, they

are typically transferred to a specialized pediatric or children's hospital.

Given the reimbursement structure and

the governmental payers that cover families and children,

Medicaid, which is, remember, the state operated and

managed program where both federal and state monies are combined.

That's the major payer, Medicaid.

And as we have seen in Medicare, similarly here about 40% of the funds

paid for about 6% of the children who are extremely medically complex.

So, a small number drives a very high amount of the cost.

And then, some of the services that children's hospitals provide

are extremely specialized.

So for example, transplants, bone marrow transplants, or heart transplants,

very complicated heart surgeries, also complicated cancer care.

Again, children's hospitals focus on small children,

and all of the other hospitals in the region mere refer the pediatric

patients to these highly specialized hospitals.

Let's talk about in-patient psychiatry facilities, IPF, or

the psychiatry hospitals.

There's about 1,500 of those, 400 are freestanding, so

they are in a building on their own, and 1,100 reside within other hospitals.

So it might be a unit or

it might be a smaller section of a larger hospital campus.

Now, about a third of the time, one particular diagnosis,

and this is a psychiatry diagnosis called psychosis, accounts for

most of these patients and most of these admissions.

There has been noted a growth in the for

profit inpatient psychiatry hospitals and that is under review.

So data is available through the MetPath that we've looked at before regarding

the margins, the growth, and other metrics for inpatient psychiatry facilities.

Now, given the extreme review of mental and

behavioral health in the United States and also across the world.

These hospitals are a critical nature of the backbone and safety net for

patients who are struggling with these very important medical conditions.

Let's do a short quiz.

Now, let's briefly cover what is a tertiary care hospital.

So, this is a hospital that is typically large and

has many highly specialized services.

So, it likely would have very specialized equipment, very specialized staff,

and also the make up of the hospital would be highly specialized and complex.

Typically, this particular hospital will have a referral networks.

So, we'll have a feeder system from smaller hospitals

that do not provide these level of specialty services.

And those hospitals might have referral

networks to the smaller critical access hospitals.

So again, patient presents here, too complicated, might go to the next level.

Still too complicated, might go to this tertiary care hospital.

Some of the examples of services are transplants,

very complicated trauma cases, high risk pregnancy,

child birth and new born care.

Again, we've discussed that in children's hospitals as well.

And then they typically will have highly specialized radiology,

for example, PET scans and other very costly and

very specialized radiological services.

Finally, let's talk about the single specialty hospitals.

Typically, these are hospitals that are trying to leverage economies of scale and

scope.

So, they will develop competencies in one particular service line.

So most of the patients in that hospital will be of the same type with the same or

very similar conditions.

So for example, one might be heart.

And as you can imagine in Harlan's case, if he knew and

had a choice between a heart hospital that only took care of heart cases,

or could go to a general hospital that does heart in one area, but

does other services.

That may be one consideration for Harlan and his family.

Again, it all depends upon the quality metrics, the quality metrics of

these two hospitals, and that's exactly the point of what is being looked at.

Are these single specialty hospitals in fact more efficient.

So, do they reduce overall cost, and do they increase quality?

So again, we're back to this concept of that triple aim.

So do they meet all three of those triple aims, and

because of the single specialization, are they able to do that or not?

That is being reviewed and is undergoing some debate now.

In summary, single service line hospitals like psychiatry or

children's try to leverage economies of scale and scope.

Some of them like children's and

psychiatry services are extremely well recognized.

Although some of the new ones that are emerging are being analyzed right now for

value creation along the triple aim paradigm.

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