Business Commons^™

Telehealth In Critical Care: Quality And Cost Outcomes, Stephanie Cole, Michael Robie, Bukola Abodunde, Alberto Coustasse

Management Faculty Research

As the population of the United States has continued to age, there has been an increase in usage and Hospital Length of Stay (LOS) costs of Intensive Care Unit (ICU) beds. In the early 2000s, it was determined there would be a shortage of all ICU providers within the next decade due to the increased need for critical care for the aging generation. Around this time, the Leapfrog Group was formed to demand that hospitals improve quality and decrease cost. Utilization of telehealth in the ICU was a possible alternative, which had a positive impact on both clinical and financial …

Provider Based Billing In The United States: The Effect On Government Reimbursement, Victoria Walker, Uyi Lawani, Alberto Coustasse

Management Faculty Research

Introduction: Provider-based status has been a Medicare payment designation established by the Social Security Act. It has allowed facilities to bill for physician services based on facility type. Medicare reimbursement has been based on whether services were rendered at a freestanding healthcare facility or a provider-based facility. Provider-Based Billing [PBB] comprises of two separate charges from the outpatient department, including a facility charge and a professional charge.

Methodology: The methodology for this research analysis was a literature review complemented with a semi structure interview of a PBB expert. The review illustrated examples of provider-based clinics who have billed all Medicare …

Medicare Access And Chip Reauthorization Act And Rural Hospitals, Erica Kelley, Rhea Lipscomb, Jennifer Valdez, Natesh Patil, Alberto Coustasse

Management Faculty Research

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 …

Rethinking The Obvious: Time For New Ideas On Medical Malpractice Tort Reform, Jarred Gerlach, Bukola Abodunde, Marc D. Sollosy, Alberto Coustasse

Management Faculty Research

States have engaged in medical malpractice litigation reforms over the past 30 years to reduce malpractice insurance premiums, increase the supply of physicians, reduce the cost of healthcare, and increase efficiency. These reforms have included caps on non-economic damages and legal procedural changes. Despite these reforms, healthcare costs in the U.S. remain among the highest in the world, provider shortages remain, and defensive medicine practices persist. The purpose of this study was to determine how successful traditional medical malpractice reforms have been at controlling medical costs, decreasing defensive medicine practices, lowering malpractice premiums, and reducing the frequency of medical malpractice …

Implications Of Upcoding On Medicare, Katrina Cremeans, Samantha Marcum, Carli Followay, Jessica Oldaker, Alberto Coustasse

Management Faculty Research

The complexity of and amount of funds involved in Medicare has led to a significant increase in the incidence of Medicare fraud. A type of Medicare fraud, upcoding, has contributed to excessive and unnecessary health care spending. Upcoding has been an illegal strategy that some providers have used to increase their Medicare reimbursement for certain conditions. This is accomplished by coding a provided service as a more expensive service than what was actually performed. With the proliferation of upcoding, there has been an astonishing $12.5 billion in fraudulent Medicare charges since 2007. The fraudulent strategy of upcoding to increase Medicare …

Potential Savings From Consumer-Driven Health Plans, Jessica Mcnair, Brittany White, Christopher Miller, William Ferguson, Alberto Coustasse

Management Faculty Research

Consumer Driven Health Plans (CDHPs) have been identified as a high-deductible insurance option that has increased consumer responsibility while health care expenditures have decreased. Anticipated savings through the use of CDHPs have drawn increased interest of employers and policymakers. The increased need to control healthcare costs as well as healthcare utilization have also fostered the development of increased use of CDHPs. As the use of CDHPs have expanded, educated consumers have become more engaged in their healthcare services and have increased demands for transparency of healthcare costs. Healthcare costs, utilization, and moral hazard of this study are further discussed.

Personal Health Record Interoperability, Manal Alghamdi, Courtney Stanley, William K. Willis, Alberto Coustasse

Management Faculty Research

Personal Health Records (PHRs) is a software application that allows patients to review their medical information remotely through a secure domain. There are four forms of PHRs which are; 1) self-contained Electronic Health Record (EHR), 2) self-contained EHR, 3) PHRs integrated care EHR controlled by health provider and partially by the patient/consumer, 4) PHRs integrated care EHR controlled by the patient/consumer. The methodology for this study was a literature review and semi-structure interview with a specialist in health information technology. Electronic databases used included PubMed, Academic Search Premier, EBSCOhost, LexisNexis and Google Scholar. A total of 38 sources were referenced. …

The Use Of Big Data By Managed Care Organizations, Bojing Wang, Xiaoying Liu, Alberto Coustasse

Management Faculty Research

Big data have become available in all kinds of healthcare organizations. The application of big data analytics in Managed Care Organizations (MCOs) has the potential to improve health care, lower costs, save lives, and help to make better-informed decisions. The study illustrated the implication of big data in MCOs. Big data can help MCOs reduce patients’ relevance, analyze specific diseases such as asthma and diabetes. Big data also could help MCOs to reduce cost after collecting data and determined the specific patients’ situation. The implication of big data has benefited MCOs in reducing costs, improving the quality of healthcare care. …

The Impact Of Intervention Measures On Sexual Harassment In The Film And Television Industry, Ben Eng, Ralph E. Mckinney, Lawrence Shao

Management Faculty Research

Since 2017, increased sexual harassment incidents have been reported in Hollywood; yet, little guidance has been offered on how organizations, which are informally governed by their network members, can effectively reduce sexual harassment. Building upon the theory of network governance, this paper suggests social mechanisms, which are used to coordinate and safeguard exchanges between Hollywood organizations, are more effective at reducing incidents of workplace sexual harassment than traditional strategies. These social mechanisms direct change to the macroculture through collective sanctions that damage the perpetrators reputation and restrict access to network opportunities. In essence, perpetrators become toxic assets that Hollywood avoids …