I have a question need your help. Please see the attached file....

I have a question need your help. Please see the attached file.

1 Attachment
Week 6 – You decide Scenario : In Week Two, you sat in the CFO chair, studied a real world hospital Accounts Receivable (AR) problem with your team, and came up with a Process Improvement Plan to reduce Days in Accounts Receivable and improve cash flow to you hospital. Well the great news is that your plan worked! This morning your Days in AR stand at 67. Not perfect. ... but much better, and you have five payrolls of cash on hand right now. Things are looking up for Community Memorial! And then just before lunch you get a call from the Bill Jacobs, Human Resource Director at Commercial Intertech (CI), the largest employer in the community. Bill says, "I wanted you to hear it from me first. We signed a contract yesterday with MegaPlan Health. They will be the managed care organization for all 4,500 of our employees and their families. About 9,000 patients total. I'm sure that you will want to get a contract with MegaPlan as soon as possible. I noticed that your hospital is not on their Preferred Provider Network (PPN), and I am pretty sure that you will want to be, so that our employees can continue using the facility." By the time you thank Bill for the heads up, the acid is already churning in your stomach. In the hospital world, MegaPlan is known for cut-throat tactics, negotiating steep discounts with hospitals, and fighting every claim the hospital makes. Commercial Intertech has every right to contract with any health insurance provider they like, but now you have a problem. If you cannot get a decent contract with MegaPlan and become part of their Preferred Provider Network (PPN), many local patients may bypass your hospital and go the next closest PPN facility. Delivered to your office this afternoon, by no coincidence, is a contract proposal from MegaPlan. It calls for the hospital to provide a 35% discount from charges to MegaPlan and all of its members. And it includes service pre-authorization requirements which will make life very difficult for your business office. You know from experience that the hospital loses money whenever the discount from charges exceeds 20%. Your Role : You are the hospital CFO, trying to solve the managed care problem. Key Players : Dr. John Evans, Chief of Staff : I know you are not going to like this, but probably 1/3 of my practice comes from Commercial Intertech. ...employees, spouses, kids. I have had multiple generations of patients who all work out there. You need to sign a contract with MegaPlan and soon. I looked at a contract for my own office. It is not great, but if I don't sign I could risk losing many of my long-time patients. And sorry to say this, but if the hospital does not sign. ..... frankly I might have to take my patients elsewhere. Katrina Eaton, CEO : Well, we do need to form a relationship with MegaPlan if Commercial Intertech has selected them. I would suggest preparing your own contract proposal for them to look at. Be reasonable, but make it something we can live with. Remember, we have some power in this situation ourselves. If the Commercial Intertech employees and families cannot use our hospital, they will be forced to travel a long way for care, and may even have to change doctors. That will not make them happy at all. You can bet that the HR folks at the factory will get an earfull from their employees if we cannot come to terms with MegaPlan. Make your own counterproposal, and don't panic.
Background image of page 1
2 pages
Answer & Explanation
Verified Solved by verified expert

ultrices ac magna. Fus

dictum vitae odio. Donec aliquet. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nam lacinia pulvinar tortor nec facilisis. Pellentesque dapibus efficitur laoreet. Nam risus ante, dapibus a molestie consequat, ultrices ac magna. Fusce dui lectus, congue vel laoreet ac, dictum vitae odio. Do

Unlock full access to Course Hero

Explore over 16 million step-by-step answers from our library

Subscribe to view answer
Recently Asked Questions
Explore recently asked questions from the same subject