Business Commons^™

Is Upcoding Anesthesia Time The Tip Of The Iceberg In Insurance Fraud?, Alberto Coustasse, Mike Frame, Avinandan Mukherjee

Management Faculty Research

The question of whether there is anomalous billing in anesthesia care is beginning to be asked by operating room managers, health care administrators, policy makers, and regulators. This question may arise when an anesthesia case seems to take more time to complete than it should. Audits, when conducted, have found that an unusual number of claims end with the digits 0 or 5 as if large numbers of cases start or end on the 5-minute mark. Such a finding serves as a red flag for that practice to undergo an audit. Questions may also be raised because the percentage of …

The Continuing Epidemic Of Hepatitis C In The United States: The Case Of West Virginia, David P. Paul Iii, Neha Botre, Maggie Phillips, Jumana Abboud, Alberto Coustasse

Management Faculty Research

Hepatitis C virus (HCV) is one of the most significant public health problems currently facing the U.S. If it is left untreated, the likelihood of sustaining a treatment response decreases. While early identification has been identified as a critical focus in trying to obtain better health outcomes, new drug treatments appear quite promising.

The 340b Program, Contract Pharmacies And Hospitals: An Examination Of The First 25 Years Of Their Increasingly Complex Relationship, David P. Paul Iii, Morgan Cathlene Ludado, Morgan Ruley, Hannah Sayre, Alberto Coustasse

Management Faculty Research

The 340B Drug Pricing Program, created by Congress in 1992 through the Veterans Health Care Act, has provided discounted drug prices to hospitals and other health care organizations serving a wide population of low-income patients. Some 340B programs use contract pharmacies, an arrangement whereby the hospital or health care organization signs a contract directly with a pharmacy to provide covered pharmacy services at discounted prices.

The federal 340B Drug Pricing Program has provided access to reduced price prescription drugs to over 35,000 individual healthcare facilities and sites certified by the U.S. Department of Health and Human Services (HHS), and clinics …

Telepharmacy And Access To Pharmaceutical Services In Rural Areas, Raghav Sarkar, Brandon J. Metzger, Hannah M. Sayre, Chelsea M. Slater, Sruthi Katamneni, Alberto Coustasse

Management Faculty Research

Access to pharmaceutical services in rural areas has been affected by a national shortage of pharmacists. Telepharmacy, a subspecialty of telemedicine, has involved the utilization of telecommunications to deliver pharmaceutical services to consumers located at a distance. The number of telepharmacy programs in the United States and worldwide has been progressively increasing. The purpose of this research project was to examine the effect of the utilization of telepharmacy on rural hospitals’ access to pharmaceutical services. The methodology of this qualitative study was a literature review. Four electronic databases were employed to retrieve peer-reviewed journal articles, and three websites were accessed …

Hospital Nurse Burnout: A Continuing Problem, David P. Paul Iii, Lama Bakhamis, Harlan M. Smith Ii, Alberto Coustasse

Management Faculty Research

RNs are a critically important component of the U.S. healthcare system. RN burnout – the feeling of exhaustion from working long hours without rest – is a real concern, having been reported in many hospitals. We examine the background, causes and consequences of burnout among RNs in U.S. hospitals, in order to identify solutions to this problem. Findings indicate that Burnout Syndrome in RNs can be analyzed in terms of four clusters of characteristics: individual, management, organizational, and work. The consequences of burnout include increased RN turnover rates, poor job performance, and threats to patient safety. RN burnout in hospitals …

Macra And Rural Hospitals, Erica Kelley, Rhea Lipscomb, Jennifer Valdez, Alberto Coustasse

Management Faculty Research

The purpose of this research was to study MACRA (Medicare Access & CHIP Reauthorization Act) and to determine how its implementation would financially impact rural hospitals. Although the long-term effects of MACRA have not been able to be studied, MACRA has the prospective to negatively impact rural hospitals financially. MACRA has potential risks and benefits for physicians associated with its two reimbursement payment methods. The estimated negative reimbursements and set reductions to hospital reimbursement have supported the idea that physicians and all healthcare organizations need to be aware and prepared for MACRA.

The Opioid Epidemic In West Virginia, Nicholas Bowden, Rachel Merino, Sruthi Katamneni, Alberto Coustasse

Management Faculty Research

The rate of overdose-related to the use of licit and illicit opioids has drastically increased over the last decade in the U.S. The epicenter being West Virginia the highest rates of overdoses accounting for 41.5 deaths for 100,000 people among the 33,091 deaths in 2015. The number of people injecting drugs has increased from 36% in 2005 to 54% in 2015. The total U.S cost of prescription opioid abuse in 2011 has been estimated at $25 billion, and criminal-justice-system costs to $5.1 billion. The reasons for this opioid epidemic incidence in WV have been a combination of sociocultural factors, a …

The Impact Of Big Data On Chronic Disease Management, Niharika Bhardwaj, Bezawit Wadajo, Anthony Spano, Alberto Coustasse

Management Faculty Research

Introduction: Population health management – and specifically chronic disease management – depend on the ability of providers to identify patients at high risk of developing costly and harmful conditions such as diabetes, heart failure, and chronic kidney disease (CKD). The advent of big data analytics could help identify high-risk patients which is really beneficial to healthcare practitioners and patients to make informed decisions in a timelier manner with much more evidence in hand. It would allow doctors to extend effective treatment but also reduces the costs of extending improved care to patients.

Purpose: The purpose of this study was to …