Health Care Entities Essay
Identify at least 2 additional health care entities that could be represented in the infographic.
Health Care Entities
Describe why these entities can be represented in the infographic
Example: Architecture and Interior Design Firms (facility design)Health Care Entities Essay
Facility design firms provide products and services to different health care facilities that are planning to build new or redesign their current building space. They fit within this infographic because the designers need to understand medical terminology and health care concepts to build an effective space for their health care clients.
Suggest the key financial drivers that most likely will cause health care organizations to merge. Provide support for your rationale. Cost is the driver that will most likely cause healthcare organizations to merge. Most healthcare organizations have issues with spending. Most industries today are faced with a variety of obstacles in achieving or remaining profitable. The healthcare industry is no exception. Profitability is enough of a challenge under normal circumstances, but especially so during fragile economic times. Uncertain revenue streams and rising costs have many healthcare organizations understandably apprehensive.
There are many financial ratios used in evaluation of a healthcare organization’s performance but for purpose of this study, it will be limited to activity, leverage investment, liquidity and profitability. Determine the key factors that will drive the financial planning process for most organizations in the post-merger phase, and examine the related impact to the organization process. Provide support for your rationale. Post-merger integration is the art of achieving the results dreamed of by investors. The merger made sense for all the right reasons—brand recognition, access to new customers, cost takeout, or global expansion—and the spreadsheets made it black and white—return on investment (ROI) in a year or less. Post-merger integration work is difficult, political, and often driven by teams that still have day jobs. Budgets are undefined, executive leadership is not clear beyond the C-level, no plans exist, and no one has done it before. Companies are willing to spend money on due diligence ahead of signing the papers, but do not always follow through to ensure that targets are met.Health Care Entities Essay
This dissertation consists of two essays that explain health outcomes and medical care in
the United States. Health care has been a major concern of economists and policy makers. Policy
intervention is one of the key factors that affect health outcomes, especially among low-income
families. Welfare programs such as Medicaid and cash assistance are conventionally
implemented to assist low-income families. The effectiveness of these efforts to improve health
outcomes and medical utilization among low-income families is not entirely clear. As to the
supply side of health care, the results of previous studies on how hospitals provide the services
are mixed. Additionally, hospitals may compete to attract patients and generate spillover effects.
Quality of hospitals may in turn differ by market. My two essays apply econometrics models to
investigate the effects of public policies and hospital quality on health and medical care.
Specifically, the first essay examines whether welfare programs affect the health outcomes and
medical utilization of children in the low-income families, and if so, which policy has the
strongest effect on them. The second essay explores how the spillover effects impact the
treatment rates of hospitals.
The first essay examines the effect of the Temporary Aid to Needy Families (TANF)
program on children’s health outcomes using data from the Survey of Income and Program
Participation (SIPP) over the period 1994 to 2005. The TANF policies have been credited with
increased employment for single mothers and a dramatic drop in welfare caseload. Our results
show that these policies also had a significant effect on various measures of children’s health and
medical utilization especially among low-income families. These health measures include a
rating of the child’s health status reported by the parents; the number of days an illness or injury
kept the child in bed; the number of times that parents consulted a doctor; and the number of
nights that the child stayed in a hospital.
The second essay addresses the effect of hospital ownership on treatment rates allowing
for spatial correlation among hospitals. Competition among hospitals and knowledge spillovers
generate significant externalities which we try to capture using the spatial Durbin model. Using a
panel of 2342 hospitals in the 48 continental states observed over the period 2005 to 2008, we
find significant spatial correlation of medical service treatment rates among hospitals. We also
get mixed results on the effect of hospital ownership on treatment rates that depends upon the
market structure where the hospital is located and which varies by treatment type.Health Care Entities Essay
ESSAYS ON HEALTH AND MEDICAL CARE
By
Yin-Fang Yen
B.A. National Chung Cheng University, 2003
M.A. The University of Mississippi, 2008
DISSERTATION
Submitted in partial fulfillment of the requirements for the
degree of Doctor of Philosophy in Economics
in the Graduate School of Syracuse University
May 2013
Copyright 2013 by Yin-Fang Yen
All rights reserved
v
Acknowledgements
My sincere appreciation goes to all of whom helped me complete this dissertation and
contribute my intellectual progress at Syracuse University. I would like to express my special
gratitude to my advisor, Professor Badi H. Baltagi, for his support and insightful guidance
throughout these essays. I am also indebted to Professors Chihwa Kao and Susan Gensemer,
whose encouragement is an essential part of my progress. I also benefit a lot from their wisdom.
I would like to thank Professors Jeffrey Kubik, Perry Singleton, Jeffrey Weinstein, and
seminar participants at Syracuse University for their comments and suggestions. I also would
like to thank Professors Donald Dutkowsky, William Horrace, Emil Iantchev, Jerry Kelly, Derek
Laing, Jan Ondrich, and Stuart Rosenthal for building up my knowledge in economic theory and
research technique. I appreciate the contribution of Professor Leonard Burman to my dissertation
defense. I am also grateful for comments and advices received from participants at the third
Health Econometrics Workshop in December, 2012, and the NY Camp Econometrics VII poster
session in April, 2013.
I also benefit a lot from many constructive suggestions, encouragement and help from my
classmates and colleagues. They are Ying Deng, Jing Li, Allison Marier, Wael Moussa, Liu Tian,
Sanggon Na, Jeonen Shin, Qianqian Cao, Jie Dai, Xiaoxue Li, Jinqi Ye, Ian Wright, Andrew
Friedson, Alex Bogin, Shimeng Liu, Chong Li, Shaofang Qi, Chun-Chien Hu, Pallab Ghosh,
Tingting Xiong, Melissa Chow, Mallory Vachon, and Bin Peng.
Last but not least, I am sincerely thankful to the help and support from my lovely family,
especially my parents, while I was writing up this dissertation. All remaining errors are my own.Health Care Entities Essay
During the first six months of program development, the need for an
advisory committee was clear. It was important to utilize a group of key
individuals from all schools and critical departments to provide guidance
and suggestions. Not only did forming this advisory group provide more indepth knowledge about the initiative across the university, but it also
provided the opportunity for greater involvement among stakeholders. An
initial meeting included twenty-one individuals representing the Schools of
Nursing, Medicine, Dental Medicine, Management, Law, Social Sciences,
and Engineering, the College of Arts and Sciences, staff, faculty, the
Department of Nutrition, University Technology, the Office of General
Counsel, Facilities Services, the Division of Finance, the Fitness Center, the
Urban Health Initiative, the Prevention Research Center for Healthy
Neighborhoods, Environmental Health and Safety, University Health and
Counseling Services, University Marketing and Communications, Public
Safety, HR, and the Office for Sustainability.
Since March 2013, this group has met once a month to keep abreast of
program and service developments and evaluations and to provide
guidance and insight regarding interests of constituent groups. Initial
meetings focused on discussing well-being and its importance to the
university. The premise shared was that workforce development strategy
positively impacts productivity, morale, health, and related expenses. A
variety of questions were posed to generate ideas: “Imagine a healthier
work environment at our university: how would daily work life be different
for faculty and staff? What are the top three most important changes that
should be considered? What new initiatives could be implemented?”
Additional meetings focused on considering a day in the life of faculty
and staff at the university. Discussion centered on the current barriers to
good health choices and habits, ways to avoid or remove these barriers,
existing reinforcements of good health choices and habits, top priority
areas for change and modification, and how to determine when the
program’s goals have been realized. How will we know? What will we see?
What will we hear? What will you do? How will you feel? Important
guidance was provided on the new wellness website, data analysis and
evaluation output, and communication of annual and seasonal wellness
activities. Each member of the committee was expected to provide two- or
three-year terms of service to maintain consistency and organizational
support. Most members have been interested in continuing to participate
in the committee, though a few have rotated off due to new work
8. Leonard L. Berry et al., What’s the Hard Return on Employee Wellness Programs?,
88 HARV. BUS. REV. 104, 104 (2010).
Health Matrix · Volume 27 · 2017
Creating a Culture of Health – One University’s Experience
422
commitments or because they left their positions or the university. The
committee has provided input on efforts to create a healthy environment
for faculty and staff to enable full engagement in their work, to help those
groups maintain good morale, and to support greater productivity.
B. HR & Benefits
Working closely with the HR staff and HR’s benefits staff has been
critical to successfully implementing this program. Natural alignment
between the HR department and its benefits staff exists as both are focused
on providing employees with the information, programs, and services
necessary to do a good job. HR leadership initially served as strategic
partners in reviewing implementation plans for the incentivized wellness
program that the university’s president was interested in offering. Benefits
staff members were instrumental in facilitating connections with University
Technology staff to develop online program participation attestation forms,
online wellness activity tracking, and connections with payroll staff to
automate distribution of incentive payment for participation in activities
and programs. The benefits staff provided monitoring of activity completion
by reviewing data feeds from vendors. The collaborative focus of everyone
involved has facilitated the development of this personalized university
program.
Another important aspect of the program’s success has been the close
working relationship of the two individuals directly responsible for plans
and implementation of all program details. An appropriate level of support
to actualize all program plans is a critical foundation for mission and goal
achievement. Collaboration, communication, and a unified energy and
commitment to the vision has facilitated goal achievement.
C. Wellness Champions
For wellness programs to be successful, they must engage employees
and leaders must believe in the programs. To facilitate engagement,
organizations often establish wellness champions (“champs”) to promote
the program broadly at a grassroots level. Identifying employees that would
like to serve as voluntary program ambassadors is a current industry trend.Health Care Entities Essay
One large organization keeps five-hundred site-specific wellness champions
up to date on program offerings and initiatives via monthly phone calls.9
The test-case university has begun a similar pilot initiative. The purpose of
this effort is to improve and sustain university employees’ health through a
supportive environment in which information is shared. This can be
accomplished by increasing the number of departments actively
participating in wellness programs and honoring and recognizing individual
and department efforts toward creating a healthy workplace.
A pilot initiative was developed in year one with six champs. Each
champ works as a key communicator of wellness programs, activities, and
resources. Wellness champions focus on promoting faculty and staff
9. Id.
Health Matrix · Volume 27 · 2017
Creating a Culture of Health – One University’s Experience
423
engagement and participation in the wellness program and campus
programs, services, and events, helping fellow faculty and staff understand
the program to improve utilization, and recognizing individual and
department efforts to create a healthy workplace. Wellness champions’
responsibilities include creating an email distribution list for interested
individuals and sharing monthly wellness emails with that distribution list,
following the wellness program on Facebook and sharing news with friends
when applicable, posting paper flyers in the work area as needed, attending
meetings three times annually, brainstorming ideas for greater
involvement, and offering at least one wellness initiative for their work
group annually—summertime lunch walks, healthy potluck lunches, takethe-stairs campaigns. A special booklet called “Your Easy Access Guide to
Well-Being on Campus” was developed to highlight the myriad ways in
which champs could foster wellness engagement throughout the university.
The initial workshop offered for champs was a half-day event focused
on getting to know everyone, discussing the wellness champion role,
sharing thoughts on the current program and opportunities for the future,
prioritizing personal wellness goals, and sharing details about upcoming fall
wellness activities. Wellness champions receive email updates twice a
month to keep them up to date on activities and provide important details
to send to colleagues and friends. This informal communication method has
spread the word on wellness in a more direct manner. In this technologydriven and information-filled world, sending messages via email from
colleagues is an effective way to provide information. It is this type of peerto-peer communication that directly led to one employee success story—a
champ shared information about a new online program offering and, as a
result, a colleague found the tobacco cessation program that helped her
stop using tobacco within a month. The time was right, the message was
clear, and the behavior change foundation led to cessation.
Pros: Creating a cohesive wellness team provides an opportunity for
increased involvement from all levels and areas of the organization and
allows for integration of various viewpoints.
Cons: Team members may not be knowledgeable about all program
features and may suggest deliverables that have already been offered or
considered.
Critical Questions:
• What experts work in the organization?
• How can you entice those experts to join the committee?
• What are the critical goals to set for the committee?
• What process will yield the most participation from key
leaders?Health Care Entities Essay
• What meeting frequency is necessary?
• How can the committee’s impact be communicated to
leadership and the rest of the organization?
Health Matrix · Volume 27 · 2017
Creating a Culture of Health – One University’s Experience
424
• What type of member rotation strategy will yield the best
energy, interest, and commitment?
III. Collecting Data to Drive Health Efforts
The next important step was for the medical director to examine
relevant organizational data prior to choosing a plan and appropriate
interventions. Data focusing on population health, physical environments,
and factors affecting productivity, such as absenteeism, disability, and
workers’ compensation was gathered.10 The medical director also gathered
demographic data from all faculty and staff to help understand their
gender, age, positions, ethnicity, and length of employment, as well as the
number of employees in each school, in order to develop a profile to guide
future program and service plans.
Given the presence of multiple medical insurance carriers serving
employees and dependents, an in-depth review of healthcare benefit
claims, high claimant diagnoses, top lifestyle-related conditions, most
prevalent and expensive prescriptions, health risk assessment aggregate
results, and screening trends was vital to obtain. Collecting this data
annually provided an opportunity to examine baseline data in comparison
to trends over time. As in many worksite wellness programs, three
assessment-focused interventions were incorporated into the program.
Benefit from participation was realized by the participant—for their
individual results report—and for the organization—for the de-identified
aggregate reporting.
Structured wellness programs have used health risk assessments
(“HRAs”) for decades. More recently, many higher-education institutions
have found value associated with their use in wellness programs.11
Summary reports reveal strengths and areas of opportunity regarding
individual health. Aggregate data reveals risk trends and risk migration over
time. Keeping low-risk people low risk is critical.12 Reporting HRA results
helps organizations assess whether a program is successful in meeting this
goal.
Biometric screenings help participants learn about their current health,
identify areas that may need improvement, and determine the appropriate
measures for making those improvements.13 Health protocols were helpful
in planning this aspect of the program. The biometric screenings collected
10. CWRU, supra note 6.
11. See, e.g., Cynthia J. Sieck & Allard E. Dembe, A 3-year Assessment of the Effects of
a Self-Administered Health Risk Assessment on Health Care Utilization, Costs, and
Health Risks, 56 J. OCCUPATIONAL & ENVTL. MED. 1284, 1285-87 (2014).
12. DEE W. EDINGTON, ZERO TRENDS: HEALTH AS A SERIOUS ECONOMIC STRATEGY 42-43 (2009).
13. Health Enhancement Research Organization et al., Joint Consensus Statement:
Biometric Health Screening for Employers, 55 J. OCCUPATIONAL & ENVTL. MED. 1244
(2013).
Health Matrix · Volume 27 · 2017
Creating a Culture of Health – One University’s Experience
425
information about participants’ height, weight, waist circumference, blood
pressure, cholesterol, and blood glucose.
An internally developed tobacco attestation form asked participants
whether or not they currently use tobacco. All current tobacco users were
required to participate in a tobacco cessation program the following year if
they also qualified for the university’s monthly wellness incentive program.
Data from all program efforts was summarized annually. Data from the
university’s Human Resource Information System (“HRIS”), employee
assistance program, and workers’ compensation, disability, leave of
absence, and pharmacy benefit manager was gathered. Compiling all the
data collected into one location took significant time but was necessary to
comprehensively understand the population’s health. Reports generated
from the comprehensive database provided an understanding of baseline
health status and changes over time. The most informative reports were
based on the HRA participants’ average wellness scores and their scores in
comparison to a benchmark group that took into account employees’ risk
status, their average number of risks, health risk by prevalence in the
population, health problems self-reported, self-reported health
enhancement changes, risk transition and analysis of the transition’s
significance, culture of health responses and comparison to benchmarks,
the relationship between health risks and costs, and excess costs associated
with excess risk.
Sharing key aspects of those analyses has helped the health advisory
committee understand the program’s impact. Data have been incorporated
into annual reports for communication with leadership and all working at
the university. Continuing on this track and enhancing the quality and
quantity of data will facilitate those efforts going forward.
Pros: Focusing on data within a university-based wellness program is
consistent with the research-intensive approach present in other areas of
the university, and using this type of approach lends credibility to the
program.Health Care Entities Essay
Cons: It takes a while to develop a robust database for analysis, and
legal and contractual requirements may lengthen the time it takes to
conduct data analyses. Recent government regulations may limit data
evaluation opportunities.
Critical Questions:
• Where does relevant data exist in and outside the
organization?
• How will you know when enough data have been gathered to
take action?
• How can the data be leveraged to better understand the
population?
• When will it be necessary to re-evaluate the current data
management strategy?
Health Matrix · Volume 27 · 2017
Creating a Culture of Health – One University’s Experience
426
• What information needs to be shared to understand the
benefits of a data warehouse?
• How can the value proposition be maximized for the
organization and facilitate benefit for multiple departments
through data aggregation?
• What needs to be discussed or acted upon so that the needs
of the organization are balanced with the needs of employees?
• When would it make sense to emphasize organizational
benefits over employee benefits and vice versa in terms of
strategy and operations?
IV. Crafting an Annual Operating Plan
Building a culture of well-being at the university was a critical
overarching goal for this campus initiative. University administration
established this goal to promote the faculty and staff’s health and wellbeing. Developing an operating plan that specifies goals, objectives,
timelines, roles and responsibilities, budget, marketing initiatives, and
evaluation procedures is critical.14 Confirming that the annual plan relates
to the organization’s strategic plan is a critical effort to ensure success.15
The university’s current five-year strategic plan emphasizes the importance
of building a healthy community within the academic environment.
Initial plans focused on areas that significantly contribute to health,
well-being, and prevention of chronic disease. Specific objectives included:
• increasing the number of employees who are classified as low
risk;
• decreasing the number of employees in the high-risk healthstatus category;
• monitoring program participation and satisfaction and
increasing the rate of participation over time as a measure of
employee engagement;
• targeting healthcare topics that lead to high-frequency
healthcare benefit claims and expenses; and
• decreasing healthcare benefit claims expense over time.
Initial strategy for achieving these objectives focused on areas that
contribute significantly to health and prevention of chronic disease,
including the behaviors that most significantly impact expense and healthy
lifestyles. Health-related productivity losses are significant in many
populations. Health Care Entities Essay