QUESTION

Discussion: Hospital Performance/ Types of Costs

ANSWER

Some of the key factors to consider when evaluating the operational and economic
performance of a Healthcare facility include effectiveness, efficiency, and overall success
regarding healthcare service delivery. Regarding economic performance measurements, revenue
and profitability are essential elements worth considering (Kosklin et al., 2023). Total revenue is
used to measure a Hospital's total income from all the services it offers wild operating margin is
calculated as a portion of the revenue left after all expenses have been deducted. Therefore, I
would consider the total revenue and operating margin when evaluating the economic
performance of the hospital. Performing a cost analysis would help evaluate the facility's
efficiency regarding resource utilization. Evaluating patient reimbursements and other related
factors can help assess the impact of the same on general revenue.
Regarding operational performance evaluation, some key factors that would be
considered include patient flow throughput, care quality resource utilization, regulatory
compliance timeliness, patient safety, and administrative efficacy. Factors such as bed occupancy
rate and length of stay should be considered when assessing patient flow. Higher patient flow
rates would signify good operational performance, which also indicates economic performance
(Kosklin et al., 2023). Regarding throughput, I would consider factors such as the emergency
department waiting times and patient turnaround times. General clinical outcomes and patient
satisfaction scores would be used as the best indicators to assess the quality of care. Clinical
outcomes can be obtained by analyzing all patient-based operations, while patient satisfaction
scores can be obtained through surveys and interviews. Factors such as equipment utilization and
labor productivity can be used to evaluate whether or not a healthcare facility fully productively
utilizes its resources.

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Discussion 2: Types of Costs

The cost-sharing concept is used in health insurance and refers to determining who pays
what percentage of the general hospital bill. The bill can be cleared by the hospital or the
insurance facility alone or through shared effort based on the prevailing circumstances and terms
of engagement (Biener et al., 2021). The costs that can be shared between the patient and the
insurance facilitator include deductibles, co-payments, coinsurance, out-of-pocket maximum
limits, and non-covered services. Deductibles are the initial amount an insured patient is
expected to pay before the insurer takes care of the expenses. Payments catering to hospital
stays, doctor's visits, and prescriptive medications can be considered co-payments. The out-of-
pocket maximum limit refers to the maximum amount of money a patient has to part with to
cover medical expenses. If the patient reaches that payment limit, the insuring facilitator parts
with the rest of the bill for a given time frame as agreed under the insurance terms. Non-covered
services are payroll costs that may not be covered by an insurance plan, including treatments that
may not be deemed medically necessary.
Cost-sharing can have potential advantages and drawbacks to both the beneficiary and the
insurer. Even though the extent to which benefiting goes is not constant, the primary cost-sharing
beneficiaries include insurance companies, insurance consumers, and the overall healthcare
system (Biener et al., 2021). Cost-sharing mechanisms can help insurance facilitators manage
potential risks and control healthcare spending. Risk management and Healthcare expenditure
control can be attained by making patients take care of a portion of the bills while the insurance
firms offset the rest of the financial liability to stabilize premium rates. Cost-sharing can make
patients more mindful of their healthcare expenditures, which is beneficial to both parties. Cost-
sharing incentivizes healthcare providers, insurance providers, and patients to evaluate