Project #29606 - Week 4

Case Study: Stakeholder Dynamics

In the course text, read the “Business Feels the Consequences of the Uninsured Problem” case on page 273 and consider how you would evaluate the uninsured problem from a stakeholder perspective.

1.      Problem Statement: In your own words, describe the uninsured issue and its consequences.

2.      Stakeholder Analysis: Analyze how this issue impacts the following major stakeholder groups:

a.       Providers: Hospital

b.      Providers: Physicians

c.       Consumer: Employers

d.      Consumer: Patient

e.       Third- party payers (insurers)

f.       Government

Your analysis should include the overall perspective of each stakeholder group and the impact on cost, quality, and access from each stakeholder’s perspective. Refer to Table 14-2 on the top of page 274.

3.      Industry Perspective: Based on your stakeholder analysis, explain the healthcare industry perspective on this issue over the next three years. Provide a discussion of this issue from a cost, quality, and access point of view. Summarize the overall industry perspective.

4.      Conclusion/Recommendations: Finally, what is your overall evaluation of the problem of the uninsured from a stakeholder perspective? Offer a recommendation(s) for how this issue can be addressed using the parity of health care model. Be sure to support your recommendation(s) with scholarly and/or peer- reviewed resources.

Your assignment must be a maximum of six pages (excluding title and reference pages) and formatted according to APA style as outlined in the Ashford Writing Center. Utilize a minimum of five- to- seven scholarly and/or peer-reviewed sources that were published within the last five years to support your response/justification.
Case Study: Overburdened Emergency Departments Threatened by the Problem of Uninsured

Emergency departments across the nation are in crisis because of the “perfect storm” caused by the gargantuan uncompensated care burden of the uninsured, lower reimbursements, and government regulation 271272(such as EMTALA).33 The Emergency Medical Treatment and Labor Act (EMTALA), an unfunded mandate passed into law in April, 1986, requires emergency departments of participating Medicare hospitals to screen and treat anyone with an emergency medical condition. The viability of hospitals is severely compromised by an emergency department function that reels as the rank of the uninsured grows.33 Unless something is done (to include dealing with the nation’s uninsured), average Americans will find it increasingly difficult to access emergency care in their communities.34,35

Americans with chronic disease and without health insurance significantly add to the overuse and abuse of hospital emergency rooms.35 Sixty-three percent of uninsured Americans with chronic diseases have incomes less than 200% of the poverty level as compared to 18% of the insured.35 Emergency departments are overburdened by inappropriate use by the nation’s uninsured chronically ill.35 The uninsured utilize the emergency departments of local hospitals at twice the rate of insured persons.35 The care provided in the emergency department is not the most effective, efficient, or efficacious for primary or acute care needs.33 The results of years of emergency department misuse include over 1100 closed emergency departments in the past decade, exhausted staff, physicians refusing to work in the ER, and inefficient primary care.33 Emergency departments are in serious trouble given the state of healthcare, regulation, and the uninsured (uncompensated care). It is not unusual for many hospitals around the country to simply, and often unexpectedly, close their ERs for a short time to reduce growing financial losses.36 A significant number of emergency department patient visits are from the nation’s 42 million Americans without health insurance.33

The financial burden of uncompensated care is severe for hospitals and physicians across the nation. “Nationally, an estimated 150,000 people owe $50,000 or more in unpaid medical bills and an estimated 20% of the 1.4 million bankruptcies each year are due at least in part to high medical expenses.”30 In Michigan, “hospitals reported charges of over $1.1 billion for uninsured and uncompensated care in 2000 with associated costs of $456.2 million after accounting for recoveries, offsets, and private payment receipts.”36


Case Study: Business Feels the Consequences of the Uninsured Problem

Not only do healthcare costs reduce our nation’s ability to compete in the global marketplace, but also the loss of productivity due to illness or injury is of concern to any business. For the uninsured, time away from work further complicates family financial issues but also decreases overall productivity of the nation. Median time away from work in 2000 due to illness and injury was 6 days (median for males = 6 days; females = 5 days).42 A total of 1,664,000 days away from work were reported (those that were reported) in 2000.43 In 1996, temporary illness or injury resulted in 1,234,000 people between the ages of 20 to 64 years to miss work.44 Using the

median days missing work per person (6 days) and the number of people missing work due to temporary illness or injury (1,234,000) by the percentage of Americans without health insurance (14.6% and removing the 24.7% of the uninsured that did not work), a crude estimate of workdays lost is calculated to be nearly 814,000 days attributed to uninsured working Americans. If those Americans had health insurance, how many days of missed work and productivity could have been avoided? If only 20% of those lost workdays of the uninsured could have been avoided, over 160,000 workdays could have been added to the nation’s productivity.

How do you evaluate the problem of the uninsured from a stakeholder perspective? Use the template or model below to summarize your thoughts and discuss this problem with others.


Subject Business
Due By (Pacific Time) 05/09/2014 12:00 am
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