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Full-Text Articles in Business Administration, Management, and Operations

Assisted Living: Trends In Cost And Staffing, Amy Kisling, David P. Paul, Alberto Coustasse Jul 2015

Assisted Living: Trends In Cost And Staffing, Amy Kisling, David P. Paul, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

Assisted living communities (ALFs), which provide a community for residents who require assistance throughout their day, is an important part of the long-term care system in the US. Trained individuals assist residents with activities known as Activities of Daily Living (ADL). The costs of ALFs are paid either out of pocket, by Medicaid or by Long-Term Care Insurance (LTCI). Medicare does not pay for ALFs. Monthly costs of ALFs have increased over the past five years on an average of 4.1%. The major reason for this cost increase is probably the increased healthcare needs of the baby boomers generation, but …


Managed Care And Accountable Care Organizations, David P. Paul, Diego Arroyo, Bethany Daniel, Heather Graves, Krisitn Neal, Alberto Coustasse Jul 2015

Managed Care And Accountable Care Organizations, David P. Paul, Diego Arroyo, Bethany Daniel, Heather Graves, Krisitn Neal, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

Managed care generally, and more specifically, accountable care organizations (ACOs) have attempted to provide coordination of patient care in order to eliminate or reduce unnecessary procedures and or test redundancy. The purpose of this research was to study the effects of managed care in accountable care organizations by decreasing health care costs by increasing efficiency in health care.


The Balanced Scorecard Framework-A Case Study Of Patient And Employee Satisfaction: What Happens When It Does Not Work As Planned?, Andrea Lorden, Alberto Coustasse, Karan P. Singh Jun 2014

The Balanced Scorecard Framework-A Case Study Of Patient And Employee Satisfaction: What Happens When It Does Not Work As Planned?, Andrea Lorden, Alberto Coustasse, Karan P. Singh

Alberto Coustasse, DrPH, MD, MBA, MPH

Background: The successful utilization of the balanced scorecard (BSC) framework in health care has been demonstrated in the literature. Given these successes, a financially struggling hospital implemented a BSC framework intervention which attempted a culture change centered upon patient satisfaction which it hoped would translate to improved financial stability. Despite the evidence of BSC successes, the intervention, entitled Route 99, did not succeed in this hospital. Purpose: This case study was conducted to identify learnable lessons and confounding factors associated with the successes and failures of Route 99. Metrics for patient satisfaction and employee satisfaction were examined as reflections of …


Hospital Costs And Clinical Characteristics Of Continuous Renal Replacement Therapy Patients: A Continuous Ethical Dilemma, Alberto Coustasse Jan 2014

Hospital Costs And Clinical Characteristics Of Continuous Renal Replacement Therapy Patients: A Continuous Ethical Dilemma, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

This study describes the clinical characteristics and examines hospital costs involved in the care of 117 patients undergoing Continuous Renal Replacement Therapy (CRRT) between January 1999 and August 2002. The majority (70.9%) of the patients undergoing CRRT expired in the hospital. Statistically significant differences were found with respect to the length of stay for discharge status and gender; and with respect to costs for surgery versus no surgery and gender. Significant differences were also found between discharge status and gender, age, and cardiovascular surgery. The results of this study raise economic and ethical questions related to the cost/benefit of CRRT …


Comparative Cost Analysis Of Crrt In Icu/Ccu Patients Undergoing Cardiovascular Surgery Vs. Other Procedures At A Texas Hospital, Tejaswi Belavadi, Alberto Coustasse, Douglas Mains, Antonio A. Rene Jan 2014

Comparative Cost Analysis Of Crrt In Icu/Ccu Patients Undergoing Cardiovascular Surgery Vs. Other Procedures At A Texas Hospital, Tejaswi Belavadi, Alberto Coustasse, Douglas Mains, Antonio A. Rene

Alberto Coustasse, DrPH, MD, MBA, MPH

The purpose of this study was to conduct a comparative analysis of hospital costs incurred by patients undergoing Cardiovascular Surgery (CVS) and patients undergoing other medical procedures who received Continuous Renal Replacement Therapy (CRRT) in a teaching hospital. A total of 117 patients were identified through review of medical charts for the period of January 1999 to August 2002. Twenty one percent of them were identified having CVS. Eighty-eight percent of the CVS patients admitted to the ICU for CRRT died compared to 67% for non-CVS patients (p=0.047). Average actual costs of hospitalization were $47,225 for CVS patients and $51,724 …


Financial Incentives: Pay For Performance (P4p) And The Chronically Ill Patients, David Conley, Alberto Coustasse Sep 2013

Financial Incentives: Pay For Performance (P4p) And The Chronically Ill Patients, David Conley, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

P4P is the reimbursement incentive that is based on quality improvement, efficiency, which is dominating the healthcare landscape and CMS. A literature review was conducted to search for and review significant information regarding P4P and how it pertains to chronic conditions and reimbursement methods. This literature review displayed while some programs were able to display a benefit/ profit for those involved such as insurance companies, hospitals, physicians and/or patients, most programs were unable to establish quality measures, cost effectiveness and positive program outcomes worth noting.


Organizational Culture In A Terminally Ill Hospital, Alberto Coustasse, Douglas A. Mains, Kristine Lykens, Sue G. Lurie, Fernando Trevino Jul 2013

Organizational Culture In A Terminally Ill Hospital, Alberto Coustasse, Douglas A. Mains, Kristine Lykens, Sue G. Lurie, Fernando Trevino

Alberto Coustasse, DrPH, MD, MBA, MPH

This study analyzed an organizational culture in a community hospital in Texas to measure organizational culture change and its impact on Patient Satisfaction (PS). The study employed primary and secondary data, combining quantitative and qualitative methods for a case study. Participant observation was used and archival data were collected to provide a better understanding of the organizational culture and the context in which change was taking place. This study also applied a “Shared Vision” of the organization as the central process in bringing forth the knowledge shared by members of the community hospital who were both subjects and research participants. …


Uncompensated Care Cost: A Pilot Study Using Hospitals In A Texas County, Alberto Coustasse, Andrea L. Lorden, Vishal Nemarugommula, Karan P. Singh May 2013

Uncompensated Care Cost: A Pilot Study Using Hospitals In A Texas County, Alberto Coustasse, Andrea L. Lorden, Vishal Nemarugommula, Karan P. Singh

Alberto Coustasse, DrPH, MD, MBA, MPH

The financial ramifications of uncompensated care cost (UCC) on the healthcare industry have been difficult to quantify. With the lack of a standardized definition of uncompensated care and the need to account for the uninsured, indigent, and immigrant populations, the authors identified $190 million of UCC from Southwestern border hospitals for emergency room treatment of undocumented immigrants and $934 million of uncompensated care charges for 23 hospitals in a Texas county, which translated to $353 million of UCC. Although lawmakers passed the Medicare Prescription Drug Improvement and Modernization Act (2003) to address the growing imbalance, the shortfall of funds highlights …