Invitation To Discover Job Smart System Benefits 

JSS Is Our Proprietary Job Smart System > Your Best Practice Advantage

Our JSS/Dashboard Matrix Services Employ:

An On Demand - Fully Supported [RSR] Recruitment-Selection-Retention Intelligence Software; Providing Licensed Users of Variable On Line JSS Packages  & Professional Consulting Time For Training & Evaluation.

JOB SMART SYSTEM MERGER ASSESSMENT AND RISK ANALYSIS

CHECK ALL THAT APPLY

[ ] Restructuring reasons are valid for pricing and geography

[ ]Consolidation commitment to trim administrative functions, marketing, finance, public relations, and human resources.

[ ]Prop up a weaker facility that may not survive if left on their own but adds value

[ ]Resist market forces that would otherwise lead to closure and clinical consolidation.

[ ]Reorganize clinical services

[ ] Purchase physician practices to ensure a ready supply of patients to strengthen market share

[ ]Reduce overlapping market area

[ ]Increase efficiency

[ ]Create economies of scale

[ ]Improve quality of care

[ ]Reduce duplication of services and equipment

[ ]Reduce over-supply of beds and facilities

[ ]Consolidate services and facilities,

[ ]Respond to competition for quality improvements,

[ ]Hospital board is motivated to optimize patient care without cutting corners.

POSITIVE OUTCOMES YOU ARE COMMITTED TO ACHIEVING 

CHECK ALL THAT APPLY

[ ]Patients are better off

[ ]Physicians are happier

[ ] Staff in all areas of the facility are happier

[ ] Staff in all areas of the facility are more efficient

[ ] Union is on board with support to changes

[ ] Staff in all areas have the resources necessary to achieve quality of care

[ ]Facilities are used efficiently cardiology, obstetrics, behavioral health, and psychiatry

[ ] Services in DRG communities make better sense than they did before, or would ever have without the merger, from a policy viewpoint

[ ]Significant progress in improving efficiency

[ ]Economies of scale are valid for purchasing supplies and medical devices in bulk

[ ]Fundamental changes have occurred in terms of total hospital capacity or consolidation of specialized services.

[ ] Hospital has gained strength through size and improvement in their bargaining power in negotiations with health plans and can better resist price cuts

[ ]Increased ability to compete for managed care and other health plan contracts

[ ]Increased coverage of broad geographic territory to offer a full range of services;

[ ]Consolidation of many administrative functions, such as marketing, finance, public relations, and human resources, which results in substantial savings

[ ]Integration of cultures that promote discussion among physicians to create services that encourage collaboration and exchange of ideas

[ ] Creation of system-wide medical information systems

Creation of medical protocols and guidelines to improve quality of care

POTENTIAL NEGATIVE INCENTIVES  Check all that exist

[ ]Size of the merger will actually hamper downsizing in a geography

[ ] Motivation is grabbing market share or [ ] improving the stock price.

[ ]Lower quality of care by reduction in staffing

[ ]Higher prices

[ ]Hospital rate regulation will hamper solvency

[ ]Hospital system will be rewarded for maintaining multiple facilities and services, rather than consolidating or eliminating duplicative services

[ ]Protecting inefficiency and excess capacity rather than reducing them

STAYING AHEAD OF THE CURVES What resonates with you ?

·         Mergers by both suppliers (hospitals, physicians) and purchasers (health plans, insurers) which lead to a market place with only a few large players—may weigh in the balance of producing a kind of          [ ]equilibrium or  [ ]stalemate of buyers and sellers. Health plans need the hospital systems in order to ensure enrollees access to a large portion of providers, and the hospital systems need the health plans to assure a patient base. [ ]No one seems ready to end the arm wrestling. 

·         [ ]Employers need to be educated on wellness and prevention. They have not been pressuring for downsizing the hospital system, for several reasons: a few years of deceleration of health care costs that is now escalating again. [ ]Employees’ and unions’ continue to push for a broad choice of providers. [ ]This plus the fact that many business leaders are on the boards of their community hospitals and therefore have conflicting interests.

·         [ ]Employers, who want a leaner and more efficient hospital industry, will need to be less passive about the structure of that industry. If they actively try to reduce redundant capacity and channel their employees and their families to hospitals with the best performance records, they will incur some opposition. This will happen not only within the health care industry, but also from employees used to wide-open access. If employers are not willing to take such risks, however, they are unlikely to see much change in the near future. As such, they now feel that they are buying hospital care from a more concentrated and less responsive industry.[ ]

·         [ ] Senior medical staffs THAT continue to resist mergers and change and try to protect their "fiefdoms" are a barrier to consolidation of services, which are integrated across disciplines.

·         [ ]Money continuing to be misspent on advertising, buying physician practices, requiring physicians to admit to selected hospitals, and other tactics that waste money should be noted and eliminated as waste.

·         [ ]Money should be spent on better training for nurses, more nurse FTEs, clinical tiers that work, and improved data systems.

·         Competition is positive and but has negative curves that can take away from good patient care. When hospital systems decide how to spend their money it often results in the need to cut corners. One of the misperceived easiest things to cut is usually staffing levels or other things that directly affect patient care. [ ]Staffing FTE's needs to be carefully evaluated by productivity, safety, and quality standards.

·         The federal government will continue to guard against anti-competitive behavior in the hospital industry in light of the dramatic consolidation that has occurred. In particular, the prospect of large and medium-size market areas being dominated by just a few e.g. three major hospital systems—or even two—has led to higher monitoring by the Federal Trade Commission and the U.S. Department of Justice. They will continue to monitor markets carefully to determine the consequences for the local health economies. These agencies continue to try and will eventually establish clear criteria for determining whether meaningful competition exists. [ ] Mergers must have a remedial action plan, which should be taken when appropriate.

·         [ ] Policy makers will eventually see that they should not rely on mergers to reduce excess capacity and produce efficiencies in the short term. Some state representatives now are looking at other ways to encourage reduction in duplication of services, oversupply of beds, and so forth. If purchasers want the excess capacity in the system reduced relatively quickly, they will have to take steps on their own to pressure for change—through their contracts with health plans and providers—rather than relying on the hospital industry to do this on its own.   

·         Many states are contracting with health plans—or in some cases, directly with provider systems—for health benefits for their own employees’ and for Medicaid recipients. In their negotiations with plans and providers, states continue to establish criteria based more on how provider systems foster quality improvement and the efficient use of services and facilities. [ ] The trend seems to be to place less emphasis on requiring that provider systems have the most inclusive networks of hospitals and physicians. This is a state-by-state initiative.  

[ ] States could encourage private employers to promote efficiency in the health care industry by developing and sharing methods of measuring quality and efficiency or by collaborating with private employer groups for more selective purchasing. This type of cooperation is occurring today in Minnesota, Missouri, California, and Massachusetts.