The Health Care Manager

Medicare Access and CHIP Reauthorization Act and Rural Hospitals The cost of health care within the United States has continued to increase, whereas the quality of patient care has generally decreased in some areas. With the continued use of Medicare's former physician reimbursement algorithm, termed sustainable growth rate, national expenditures within the United States have been expected to increase 5.6% annually. To modernize the delivery and financing of care, Congress has introduced the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which has permanently eliminated and replaced the sustainable growth rate. The purpose of this study was to review MACRA and its implementation to determine how it would financially impact rural hospitals. Two reimbursement pathways have been created for physicians under the MACRA. In addition, the financing and competition among facilities created by the act have been expected to impact physicians and health care organizations. Rural hospitals have been set to receive reduced government reimbursements and have been predicted to compete poorly with larger hospitals and health care corporations. Furthermore, the payment tracks available through the act have been projected to impact solo and small practice physicians negatively.

Effects of Using Music Therapy for Patients Suffering From Dementia The purpose of this study was to discuss the mental and physical effects of using music therapy with patients suffering with dementia. Like any type of therapy, there are guidelines for measuring the effects. Music therapy can be used as a substitute for pharmaceuticals with dementia patients. The earlier the diagnosis and the earlier treatment commences for dementia patients, the more likely the treatment will work. Music therapy can reach the part of the brain where we hold memories, which is why it is used as a treatment option for dementia patients. Alzheimer disease and dementia are among the most expensive diseases to treat. However, if the onset of dementia can be delayed, money can be saved. Medicare does not require that music therapy be offered in assisted living, nursing homes, or hospices. Areas of cost savings were identified as use of medication, length of nursing visits, and number and length of home health-aid visits, which can all be measured in total cost savings. For health care managers, it is imperative that new therapies such as music therapy be applied in health care facilities that treat dementia patients.

Health Care Management 2019 Style: Are We Having Fun Yet? Something important seems to have been lost that once made adversity in the health care workplace tolerable or even enjoyable. Many of the same tasks that used to be surrounded by fun no longer have that aura. This article explores eight structural factors that collectively explain why health care managers report having much less fun at work recently. It suggests redefining what having fun at work means in the first instance and proposes a new conception focused on pursuing worthwhile health care goals. Health care managers should abandon many former notions of fun, let fun evolve from the work itself, and trust staff members to determine what they consider to be fun at work.

Workplace Empowerment and Job Satisfaction in Portuguese Nurses: An Explicative Model Greater effectiveness of health care does occur with a more effective management of interpersonal processes. A working management environment, which ensures sufficient access to information, support, resources, and opportunities (structural empowerment), probably can promote a personal perception of capacity and effectiveness (global empowerment) in caregivers to achieve organizational objectives and job satisfaction. This study evaluated the relationship between empowerment and job satisfaction, supported by Kanter's theory of structural empowerment. This study used a convenience sample of 151 nurses from public Portuguese hospitals. The adjustment of the model and the effect of mediation were carried out with a structural equation model (path analysis) through the statistical software STATA. The results show the mediator effect of global empowerment on the relationship between structural empowerment and job satisfaction and the direct and indirect effects of “access to opportunities” in job satisfaction. Managers of these health units should consider that the more the work environment is characterized by having the resources, opportunities, and support indispensable to the good execution of the work by the nurses, the greater the global empowerment and job satisfaction. The results obtained can be an important contribution that can be adopted as a strategy in any health institution without any harm.

Team Resource Management Perception Under Managerial Coaching Skills and Organizational Climate: Cross-Level Analysis in Taiwan's Hospitals There is growing recognition of the importance of teamwork and integration of resources in the health care industry. This article studied the influence of organizational climate and managerial coaching skills on team perception of team resource management (TRM) and coaching techniques in selected hospitals in Taiwan. Structural survey method was used to measure the relationship between organizational climate, managerial coaching skills, and team perception of TRM. The participants of this research were 530 administrative staff from 12 hospitals in Taiwan. Cross-level relationship between organizational climate (group level), managerial coaching skills (individual level), and team perception of TRM (individual level) was examined. The results revealed that organizational climate had a significant influence on team perception of TRM. Second, recognition of managerial coaching skills shaped team perception during TRM implementation. Third, organizational climate had a moderating effect on the relationship between managerial coaching skills and team perception of TRM. The study concluded that positive organizational climate and good managerial coaching skills contribute to effective team management and development. Thus, it is important for health care organizations to understand the importance of coaching and mentoring and create a workplace that makes learning, growth, and adaptation possible across different departments and functional teams.

Work-Life Balance, Burnout, and Physician Wellness Work-life balance, burnout, and physician wellness have become an important focus over the last 20 years in the field of medicine. Significant work design and cultural changes are to blame for these newly recognized aspects of a physician's career and life as a whole. Unique aspects of the work environment in the United States not only contribute to these issues in the field of medicine, but also affect the US workforce at large. Stagnant responses from governmental bodies and private organizations have allowed the issue to worsen over time. Now with added attention from some leaders, both inside and outside the health care industry, along with the increasing body of research to guide these changes, there is hope for the necessary cultural change to address work-life balance, burnout, and physician wellness. Studies are available to identify the negative contributing factors, establish evidence-based prevention strategies, and help physicians to find their ideal work-life balance, avoid burnout, and achieve overall wellness. This article seeks to provide a brief background in the area of work-life balance, burnout, and physician wellness. It will also review key points of the current literature and provide a combination of solutions suggested by experts in the field.

The Best of Both Models: Key Components of a Successful Hybrid Project Management Office Model in a Health Care Organization Project management (PM) is considered an important competency for improving organizational efficiencies, and its practice is evolving in health care organizations. As a medium-sized health care organization, Ontario Shores Centre for Mental Health Sciences used a hybrid PM office model and created a PM network to connect the small, centralized PM office to the decentralized project leaders. The key components to create the PM network were (1) skilled leader, (2) organizational support, (3) infrastructure, and (4) session content. Membership grew from 12 to 45 members within the first year. The network continues to evolve to meet member and organizational needs.

Digital Health Care and the Fourth Industrial Revolution We live in a world where big medical data are being compiled. Many people make use of biometric information gathered by a variety of health care devices linked to smartphones, such as Fitbit devices. In addition, the development of medical information management schemes and the introduction of health information systems have greatly increased the possibility of using medical records stored in medical institutions. With the development of sensor technology and analytical capabilities, we have gained new knowledge through big data, stemming from the collection of data that was not important in the current medical area. Digital health care is moving toward creating value while creating utility as well based on data collected beyond the level of those collected by sensors. Only organizations that have quickly entered the market and accumulated data and have already developed advanced algorithms based on the data can be competitive. However, digital health care companies that survive in the market will lead the change and will reorganize the health care sector. In addition, a big data–based health care platform can help increase the number of e-patients through patient participation.

Prenatal Opioid Maintenance in the United States and Its Effect on Neonatal Abstinence Syndrome: The Case of West Virginia's Opioid Epidemic West Virginia's opioid epidemic has been the cause of more than 42 000 deaths each year. Opioid abuse has become an issue among pregnant mothers and has increased the effects of neonatal abstinence syndrome (NAS) in infants. The purpose of this study was to evaluate the participation of prenatal opioid maintenance to determine whether it has decreased the amount of treatment needed for NAS in infants in West Virginia. The methodology utilized a literature review complemented with a semistructured interview. Thirty-six sources were referenced for this literature review. It was found that buprenorphine maintenance therapy had the most positive effect on NAS after birth. This review also reported a lack of availability for addicted pregnant women to enroll in maintenance programs and a high dropout rate. Opioid maintenance therapy has permitted pregnant women to refrain from illicit drug use without experiencing withdrawal symptoms, and it has allowed the opportunity for their infants to have better health after birth.

A Scoring Index of Prioritization Factors Between Patients: An Iberian Comparison This study intends to develop a Prioritization Scoring Index of Iberian Peninsula comprising Portuguese and Spanish citizens, to weigh the importance assigned to rationing criteria used to prioritize patients. Data were collected through an online survey from 2 samples of 355 Portuguese and 564 Spanish members of the general public. Respondents faced 12 hypothetical rationing scenarios and should reveal their level of agreement with each one according to a Likert scale. The statements comprise 3 allocative considerations: egalitarianism, efficiency, and equity. Findings suggest that Portuguese and Spanish respondents gave greater importance to the treatments outcomes, to the severity of the illness, and to younger patients. Furthermore, Iberian respondents assigned 57% of the weighting to equity considerations, 40% to efficiency considerations, and approximately only 3% to egalitarianism. Spaniards weighted more than Portuguese both equity and efficiency considerations while weighted less the egalitarian principle. Iberian Peninsula respondents require resource allocation decisions in health to be informed by considerations of equity as well as efficiency. As the first was most valued, it seems plausible that Portuguese and Spanish respondents are willing to sacrifice some efficiency to achieve a more equitable distribution of health.