In this module, you will write an individually authored case study analysis. The case study for this module’s writing assignment is “A Small Healthcare Clinic Confronts Health Insurance Problems,” which appears on pages 441-443 of the textbook. The paper should address the three discussion questions, and all of the sub-parts of each question, that appear in the case. The length of the case analysis should be approximately 1,000 words (excluding the reference list at the end of the paper). The paper should also apply and cite at least three external references above and beyond the textbook. APA format is required. Submit the individually authored case study analysis to the Dropbox no later than Sunday 11:59 PM EST/EDT. (The Dropbox basket is linked to Turnitin.)
A small Healthcare Clinic Confronts Health Insurance Problems – Case for Chapter 9
After working for a small physician practice for several years, you’ve decided that its time for a change. Having had some experience assisting a practice manager with management, you’ve sought out and been hired as the administrator of a small nonprofit clinic that provided primary care services to an ethnically diverse population in a mid-size population area.
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The Clinic’s History
The organization started as a broader community effort, with a group of volunteers coming together over concern that residents of low income area of the community didn’t have access to basic health care. A group of retired physicians,nurses,a nurse practioner, a healthcare administrator, and a couple of community volunteers put their heads together to stategize about how to address the problem. The result was a new organization that was incorporated as a non profit, with the founders serving as the board of directors. Each of the board members agreed to make an initial contribution of $10,000, providing $100,000 in seed money to the clinic. A local church had a small building that wasnt being used that was made available to house the clinic; used equipment ,exam tables,office furniture, and a couple of computers were secured from other local healthcare facilities that had remodeled; and board members recruited friends and associates to volunteer their time to serve the patients and to make donations to assist in the venture. The clinic’s mission was to serve all corners as best they could and to not turn anyone away, even if they had little or no ability to pay for their care. This approach was successful in getting the organization off the ground.
The Patient Population
Many of the patients served come from the low income community where the clinic is located. There are many younger individuals who are beginning to start families, are employed as seasonal workers or in types of jobs and industries that don’t provide health insurance coverage, and are relatively healthy. There is a growing populationof elderly individuals who have moved into the area because housing is less expensive in the community. Some of the patients are undocumented. Many are uninsured; some can pay out of pocket for care, but some can’t.
The Current Scenario
The organization has been in existence for 10 years and has experienced some significant changes. The founders have stepped down from their leadership roles, making way for a new group of younger board members. While in Th. Beginning many services were provided for free and costs were kept to a minimum, now expenditures on staffing, new equipment, and operations have escalated. The organization still has numerous volunteers, with many medical, nursing, and other students donating their time. However, the clinic had to hire several part time workers a few years agao. Now, they have a part time medical director, a couple of young physicians who work 1 day per week, two nurses, three medical assistants, and a couple of administrative staff to meet the steady growth in patient volume and the increased complexity of the organization. Ability to pay, even on a sliding fee scale basis, and the lack of insurance coverage have become increasingly problematic. While the original model of operating the business worked for a while and was admirable in terms of meeting community needs, it is nots sustainable over the long run. Now, the organization has some new challenges.
There are three are of particular concern that the new board of directors would like you to address:
The clinic has never provided health insurance benefits to its employees. As the new administrator, you concur that this is a problem and would like to find a way to address it. While the board members don’t have much background in or knowledge about how to do this, they are willing to consider yur proposal. They have requested that you present them with a proposal that address the following:
What are the pros and cons of providing coverage? What types of coverage are available? Which are options for the organization? How much would the options cost? How much would the organization be required to pay? Should the employees share in the cost? What would be the emplyees share? What is the best option?
Another major issue is the lack of health insurance coverage of the patients. With the recent recession and job lossess that have occurred, more of the clinic’s patients seem to be uninsured clients. Again, the board would like a proposal that covers
What are the options that may potentially be available to patients? What are the pros and cons of these? Which seem to offer the best potential, given the current circumstances? How can the clinic assist its patients with learning about the options?
3. There is a possibility that the clinic might be able to apply for federal grants to keep afloat. Review the materials at this website about Federally Qualified Health Centers (FQHC) http://www.raconline.org/info_guides/clinics/fqhcfaq.php#whatis
Identify the pros and cons of applying for status as an FQHC for the clinic. Make a recommendation about what is needed and what additional steps the board might take