Health Services Administration Commons^™

Performance Outcomes Of Critical Access Hospitals: A Resource Dependence Theory Evaluation Of Change Of Ownership Versus Independence, Colette Christina Martin

Theses, Dissertations and Capstones

Critical Access Hospitals (CAHs) play a vital role in sustaining healthcare access in rural communities, yet many face persistent financial and operational constraints. A change in hospital ownership is frequently seen as a strategy to sustain these hospitals, improve access to capital, supplement administrative infrastructure, and leverage system-level expertise. However, empirical evidence regarding the effectiveness of acquisition for CAHs remains limited and mixed. Guided by Resource Dependence Theory (RDT) and the Balanced Scorecard framework, this study examines whether ownership change is associated with differences in financial performance, utilization, staffing, and quality outcomes among CAHs.

Using Medicare Cost Reports, the American …

Burnout In The Emergency Room: Corrective Measures Vs. The Absence Of Solutions, Zane Walters, Zachary Woodall

Theses, Dissertations and Capstones

Introduction: Physician burnout has become an increasingly prevalent and critical issue in healthcare systems worldwide, particularly among emergency room physicians who face high-stress, high-demand working conditions. Burnout manifests as emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment, leading to negative outcomes for physicians’ mental health, job satisfaction, and overall career longevity. This phenomenon not only threatens the well-being of physicians but also compromises patient care quality and contributes to costly turnover within healthcare organizations.

Purpose of the Study: The aim of this study was to systematically investigate the impact of burnout interventions on emergency room physicians. …

Rural Hospital Closure And Medicaid Expansion, Jason White

Theses, Dissertations and Capstones

Introduction: In the United States, hospitals in rural areas have been under financial pressure and have been closing at an increasing rate.  This reduces access to care for rural citizens.  The Affordable Care Act of 2010 was passed in order to increase access to medical care, partially through an optional expansion of Medicaid coverage to a larger percentage of the population.  As some states adopted the expansion and some states did not, an opportunity was created to examine the policy’s effect on rural hospital stability.

Purpose of the Study:  This study was designed to examine the effect of …

Social Media By Providers And Patients In Healthcare, Madison K. Howell, Jirakamon Silapabanleng

Theses, Dissertations and Capstones

Introduction: Social media platforms such as Facebook, YouTube, and Twitter have been used in various industries to create direct-to-consumer interactive opportunities. 74% of the US population were social media active users. Around 40% of adults gather their health information from Facebook, a free social networking site, which has been available on various devices and can help many organizations advertise their services as well as communicate with their patients. Social networks had a powerful influence in making health decisions because it could be used as a means to spread either positive or negative health information.

Purpose of study: The …

Hospitalists Stare Down The Covid-19 Pandemic, Sutoidem Akpanudo

Marshall Journal of Medicine

Hospital medicine is the country's fastest growing medical specialty. The role of hospitalists has evolved greatly in the past few decades. Hospitalists have become the quarterbacks in the effort to fight against the COVID-19 pandemic. The pandemic has brought about a transformational change to the practice of Hospital Medicine.

Impact On Hospital Profitability Due To Covid Safety Guidelines, Khaja Umair Shariff, Anna Noel Franklin

Theses, Dissertations and Capstones

Introduction: The pandemic of COVID 19 presented a unique challenge to hospitals and healthcare systems that they have been struggling to function in. Operating costs had increased with new protocols, planning, operating space, supplies, and staffing. This coupled with the loss of revenue has led to approximately 10% - 20% salary reductions, furloughs, and loss of benefits such as PTO and vacation days to employees. Hospital’s cash reserves are being depleted due to increased operations costs and reduced revenue. Government funding, such as the CARES Act provided by the sanction of the Department of Health and Human Services Office, …

Financial Consequences Of Covid-19 For U.S. Hospitals, Laura Petty, Trevor Mullins

Theses, Dissertations and Capstones

Introduction: The coronavirus pandemic has caused many financial issues for many businesses including putting a substantial strain on hospitals in the U.S. The impact of COVID-19 on the financial well-being of hospitals has been evaluated and the severity is still being measured as the pandemic is ongoing. The purpose of this research was to assess the financial consequences of the COVID-19 pandemic for hospitals in the United States.

Methodology: A literature review with a semi-structured interview with an expert from a local hospital was used for the methodology of this qualitative study. Five government websites and five databases …

Benefits Of The 340b Drug Discount Program, Jarrett Gerlach, Sarah Mcsweeney, Angela Swearingen, Nitesh Patil, Alberto Coustasse

Management Faculty Research

Introduction: The 340B Drug Discount Program required drug manufacturers provide discounted outpatient drugs to healthcare organizations which serve vulnerable patient populations to allow these institutions to offer more services to more people. As the 340B program expanded, controversy has centered on which entities have benefited from the program. Many healthcare organizations sold 340B drugs to well-insured patients at full price, and thus have been financially rewarded. Amendments to the program have permitted 340B providers to utilize contract pharmacies to dispense 340B medication, which has furthered the debate over which stakeholders are benefiting from the program.

Purpose of the Study: The …

West Virginia Needle Exchange Program, Briana Washington, Sara Johnson

Theses, Dissertations and Capstones

Introduction: Needle Exchange Programs (NEPs) have been controversial aspects of public healthcare due to conflicting beliefs and opinions for public policies. NEPs allow Injection Drug Users (IDUs) the ability to exchange their used equipment for clean, unused supplies.

Purpose: The purpose of this literature review was to determine the effectiveness of needle exchange programs and the impact it has had on the reduction of HIV and viral hepatitis infections in people who inject drugs. It further explores if these strategies have had a positive impact on the reduction of HIV and viral hepatitis C in West Virginia.

Methodology …

Continuing Development Of An All Payer Health Care System In Maryland, David P. Paul Iii, Taeko Matsumoto, Alberto Coustasse, Lama Mohammed Bakhamis, Mary Lynn Harshbarger

Management Faculty Research

The state of Maryland, in collaboration with the Centers for Medicare and Medicaid, developed the first all-payer system model in the U.S. in 1971, and some 35 years later in response to financial pressures, modernized this program. The focus of the modernized program was to improve overall per capita expenditure, quality of care, and the outcome of Marylanders’ health.

This study showed positive change in moving its healthcare delivery model from volume-driven care to value-driven coordinated care. Maryland hospitals have changed their mindsets to achieve the Triple Aim of cost reduction, health improvement, and quality of care improvement for the …

Public Health West Virginia 3.0, Danny Scalise, Mba Ii, David Didden, Md

Marshall Journal of Medicine

Public health across West Virginia and the nation faces a time of tremendous change. Health is influenced by individual lifestyle, social networks, living and working conditions, and general environmental conditions. As a result, the West Virginia Bureau for Public Health created the West Virginia Public Health Impact Task Force (PHITF) to develop an innovative, custom fit public health system in West Virginia. With goals of improving health, improving quality, and reducing costs, the PHITF recommended a health in all policies approach which combines innovative patient-centered public health services in every community, and asks that local public health partner with stakeholders …

Is The Nationwide Health Information Network Feasible?, Tyler Godby, Christian Gomes, Jazmine Valle, Alberto Coustasse

Management Faculty Research

Nationwide Health Information Network (NHIN) use in healthcare facilities was examined for utilization and efficacy, although the advantages are abundant, healthcare facilities have been reluctant to adopt it due to associated costs. The purpose of this study was to analyze the feasibility of a U.S NHIN by exploring and determining the benefits of and assessing the barriers to its implementation. The results of this study suggest that implementation and utilization of NHIN by healthcare industry stakeholders leads to an increased quality of patient care, increased patient-provider communication, and cost savings opportunities. Increased quality of care is achieved by reducing adverse …

West Virginia Nursing Homes: Are They Up To The Standard?, Guillermo Madero Md, Shirley M. Neitch Md

Internal Medicine

Quality measurement and performance monitoring are under continuous assessment in Nursing Homes (NH). Through this research project we assess the quality of care provided in the NH in the state of West Virginia by publicly accessible quality measurements. The methodology for this research study was through the retrieval of data from the Nursing Home Compare website in which a total of 80 NH were located and analyzed. The results demonstrate that more than 50% of NH in West Virginia are at or above the national average when compared using the Five Star Rating System by CMS, in overall rating (59%), …

Financial Advantages Of Hospitals’ Relationships With Accountable Care Organizations, David P. Paul Iii, Rodrigo Carmago, Thaisa Carmago, Stacie Deslich, Alberto Coustasse

Management Faculty Research

Accountable care organizations are groups of providers who agree to accept the responsibility for elevating the health status of a defined group of patients, with the goal of enabling people to take charge of their health and enroll in shared decision-making with providers. The large initial investment required (estimated at $1.8 million) to develop an ACO implies that the participation of large health care organizations, especially hospitals and health systems, is required for success. Findings of the study suggest that ACOs based in a larger hospital organizations are more likely to meet CMS criteria for formation because of financial and …

How Could, Should, And Would Physicians Use Facebook With Patients, Joy Peluchette, Katherine Karl, Alberto Coustasse

Management Faculty Research

After reviewing the benefits and risks of social media, we examine online discussion boards to determine the thoughts of physicians and patients regarding the use of Facebook to communicate with one another about health-related issues. Of the 290 comments analyzed, we found 42 percent were opposed to physicians using Facebook. Additionally, most (51.7 were opposed to physicians being Facebook “friends” with patients. Most opponents expressed concerns about privacy and the need to maintain professional boundaries in the physician-patient relationship. We provide suggestions for how healthcare administrators can effectively manage their social media presence and provide assistance to physicians.

Massachusetts Health Care Reform: Is It Working?, Joshua Mcadoo, Julian Irving, Stacie Deslich, Alberto Coustasse

Management Faculty Research

Before 2006, Massachusetts had more than 500 000 residents who lacked health insurance. Governor Mitt Romney enacted landmark legislation requiring all residents to obtain health insurance. Also, the legislation established a health insurance exchange for the purpose of broadening the choices of insurance plans made available to individuals in the state. The purpose of this research was to assess the Massachusetts health care reform in terms of access, cost, and sustainability. The methodology used was a literature review from 2006 to 2013; a total of 43 references were used. Health reform resulted in additional overall state spending of $2.42 billion …

Medical Tourism And International Healthcare Options, David Conley, Andrew Sikula Sr., William Willis, Alberto Coustasse

Management Faculty Research

Medical tourism has evolved from traveling to the United States (U.S.) and a select few other countries, such as India and Thailand, to a global trend in affordable alternative healthcare. Medical tourism in the U.S. and in other countries has evolved because of cost and lengthy waiting periods. Some insurance companies are marketing kidney transplants and joint replacements through medical choice programs in order to save overall expense. As an economical approach to controlling rising health care costs in the U.S., medical tourism is becoming a valid alternative.

Is Uncompensated Care Affecting Quality Assurance Of Rural Hospitals?, Doohee Lee, Chris Dixon, Paul Kruszynski, Alberto Coustasse

Management Faculty Research

Healthcare disparities in rural areas remain significant in the U.S. healthcare industry. Uncompensated care makes healthcare disparities in rural areas worse and rural hospitals are unfavorably positioned to compete with urban hospitals in the economic downturn marketplace. How uncompensated care affects quality care among rural hospitals has been lightly investigated. As many rural residents experience difficulty accessing high quality care and the importance of establishing quality care practice standards in a rural setting, we conducted a systematic literature review to identify some quality care barriers and opportunities, suggested strategies to strengthen the position of rural hospitals in response to uncompensated …

The Case Of South African And Chilean Health Systems: Comparison Of Financial, Economic And Health Indicators, Alberto Coustasse, Peter Hilsenrath, Patricio Silva Rojas

Management Faculty Research

The purpose of this study is to identify similarities and differences between healthcare systems of South Africa and Chile. The World Health Report 2000, the Human Development Index, and financial indicators were used for comparison. Chile showed better performance than South Africa in most of the measures used. Significant progress has been made in South Africa, bringing better education, healthcare and housing to the deprived black majority. However, the HIV/AIDS epidemic, weighs heavily on health indicators. Chile decentralized its health services and implemented economic reforms during the 1980's and has had steady improvement in its healthcare indicators. Finally, these counties …

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

Management Faculty Research

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 …

Physician Incentives: Managed Care And Ethics, Douglas A. Mains, Alberto Coustasse, Kristine Lykens

Management Faculty Research

The authors review the principle features of the managed care system in an effort to understand the ethical assumptions inherent in managed care. The interrelationships among physician incentives, responsibilities of patients and the physician-patient relationship are examined in light of the ethical concerns identified in the managed care system. The managed care system creates ethical tensions for those who influence the allocation of scare resources. Managed care's administrative controls have increasingly changed the doctor-patient relationship to the businessperson-consumer relationship. Managed care goals of quality and access demand that physicians be both patient advocate and organizational advocate, even though these roles …