Questions and Answers of Health Care Financial Management

2. What are the chief similarities among case, disease, and outcomes management?
3. What are the chief diff erences among case, disease, and outcomes management?
4. How successful have case, disease, and outcomes management been?
5. Perform a PubMed search on a medical condition and case, disease, or outcomes management.Describe how the advanced search features enable you to obtain a manageable number of references.
1. Understand the goal, structure, and eff ects of physician profiling
2. Understand the goal, structure, and eff ects of academic detailing
3. Understand the goals and challenges of economic credentialing
4. Incorporate risk adjustment into comparisons of treatments and providers
5. Explain the structure of the Medicare MS-DRG system 6. Explain the factors other than treatment that aff ect health outcomes
1. What types of information should be compiled for a physician profi le?
2. What is the diff erence between a physician profi le and academic detailing?
3. What can the developers of physician profi les do to enhance the receptiveness of providers to these tools?
4. What is economic credentialing?
5. What are the goals of risk adjustment?
6. Briefl y describe each of the six patient clinical factors that can aff ect outcomes.
7. Briefl y describe the four nonclinical patient factors that can aff ect outcomes.
1. Explain the goals and process of benchmarking
2. Understand the structure of balanced scorecards and how to use them
3. Understand the structure of dashboards and how to use them
4. Apply implementation strategies and post-execution controls and incentives to increase the probability that desired changes will be incorporated into everyday routines
1. What are the benefi ts of benchmarking?
2. What are obstacles to the use of benchmarking?
3. Using CMS Hospital Compare, locate benchmarks for a hospital in your area. How does its performance compare to that of its two closest competitors?
4. Develop a balanced scorecard for the organization you work in.
5. Develop a dashboard for the department you work in.
6. What is the role of balanced scorecards, value chain, and dashboards in achieving organizational goals?
7. Discuss the three phases of implementation.
8. What can managers do to encourage change?
1. Review the history, philosophy, and goals of quality improvement and the impact of variation on performance
2. Reiterate the role of process analysis tools and SPC in quality improvement
3. Understand the role of practice policies; case, disease, and outcomes management; and reporting systems
4. Increase the value of health care services to patients
5. Speculate regarding the future of quality management in health care and understand the conditions required for reform
9. Clear Health Costs(https://clearhealthcosts.com/) is a digital app that provides prices for a range of services across market areas for what it terms shoppable procedures. Examine this company’s
8. A large orthopedic practice in the Midwest opened its own surgery center five years ago.With the growth in its physician base from 75 orthopedists 10 years ago to more than 150 today across three
7. A health club decided to offer a yearly membership. Separate fees were to be charged for nutrition counseling, tennis court usage, and aerobic instruction. How might this organization implement:
6. Assume that in problem 5 the total market for eyeglasses in this community is 2,400 pairs.What are the market-share implications of a$100 price? A $200 price?
4. Conduct a competitive analysis of two healthcare markets—Las Vegas, Nevada, and Bogota, Colombia—for plastic surgery.Examine the pricing strategy for neck-lift surgery and for eyelid
3. A marketing manger for a managed care organization reduced the MCO’s premium by 10% and saw a 20% increase in the number of subscribers. The manager thought that if the premium was reduced by
1. Explain how a pharmaceutical company’s pricing for a nonproprietary drug might change if the objective was (a) profitability, (b) sales volume, or (c) market share.
15. Price has an important positioning value, depending on how active or passive a role it plays in the promotional strategy and on the level of the price relative to the competition.
14. An organization can reduce the price for a product in several ways. Discounts can be based on volume, function, seasonality, or allowance.
13. Bundling or selling several medical services together at one set price is becoming a common strategy in health care. This strategy is becoming more common with the introduction of reference
12. Prestige pricing is counterintuitive to the economic logic of a rational buyer yet is seen as a reality in certain specialized services in health care. Too high a price, however, will lead to a
11. Odd pricing is based on item budget theory, which assumes a consumer predetermines the amount to be spent on an item.
10. In establishing price lines, there must be noticeable differences in perceived quality for the distinct lines. Price lining can be considered as part of the approach taken with the offerings of
9. In addition to break-even pricing, firms can follow a cost-plus pricing, marginal cost pricing, markup pricing, target pricing, or demand-minus price-setting policy.
8. An important consideration in pricing is determining the amount of sales needed to break even. This figure is based on total fixed costs, variable costs, and the price charged.
7. Organizations can pursue several different pricing objectives that affect their strategy:profit, sales, market share, image, and stabilization.
6. Industry structure can affect the pricing. The threat of new entrants, the power of buyers and suppliers, unused capacity, rivalry, and the potential of substitutes all affect pricing.
5. Multiple factors—such as demand, product life cycle, product line, and channel structure—affect the pricing decision.
4. The reimbursement for healthcare providers has gone through several changes—from cost-based and fee-for-service models toward a diagnostic-related group approach for hospitals requiring more
3. Federal rules have required hospitals to publish prices according to their chargemaster listing. However, companies, particularly those who are self-insured, are finding that their prices are
2. Price transparency, greater consumer engagement in negotiating for price discounts, shopping for services based on price, organizations responding with price information, and requiring upfront
1. The price an organization establishes has an economic, perceptual, and positioning value to the firm.
Learn the positioning value of price
Calculate break-even pricing
Recognize the array of alternative pricing strategies available to health care
Understand the impact of price transparency on health systems, consumers, and employers
7. Eclypsis sells electronic health record systems. The company’s marketing and sales division is having its annual meeting to set goals for the coming years. Past performance is reviewed at the
6. You are part of a strategic planning and marketing committee in a large health care system. You have been asked to make a presentation to the board of trustees because it is considering their
5. Having recently graduated from an evening MBA program where you worked closely with a team of other MBA students throughout your program, you and two other graduates spent hours together and
4. Listed here are three different organizations at various stages of the product life cycle.Explain the strategy considerations they might undertake for the specific marketing mix variable listed.
3. How would you array the following organizations in terms of the depth and breadth of their product lines: (a) a solopractice family practitioner who does not deliver babies, (b) a multispecialty
2. You have recently been hired as the marketing director for a large 120-person multispecialty clinic. The clinic has six satellite clinics as well as an after-hours clinic at three sites that begin
1. A large academic medical center was interviewing candidates for the position of marketing director. One interviewee was a vice president of marketing for a large consumer food product firm. During
13. Multiple factors have been identified that affect the rate of adoption of innovations:relative advantage, compatibility, divisibility, risk that is both financial and social, communicability,
12. Acceptance of a product is the result of its diffusion throughout the population.Individuals differ in terms of the rate at which they accept new products, services, or technologies.
11. For provider organizations in health care, the principal–agent theory underscores the importance of trust in branding. A service brand is represented by clinical and nonclinical personnel,
10. An organization’s brand name, if well known and regarded, can have value or equity in the marketplace. In deciding on the brand architecture, a firm can pursue one of several strategies: a
9. In the decline stage of the product life cycle, an organization has three possible alternatives to deal with a service: drop the line, contract the service to another organization, or harvest the
8. Organizations can stretch the life cycle in the mature phase through either product or market modification by seeking new users or new uses such as pharmaceuticals did with off-label use.
7. In the early stages of the product life cycle, a new entrant can either be priced high to skim only the most likely buyers or priced low to penetrate the largest market.
6. The length of the product life cycle is affected by uncontrollable forces such as technology,reimbursement changes, research, and demographics. An organization can impact its sales in each
5. All products and services can be described as having a life cycle consisting of four stages:introduction, growth, maturity, and decline.Although there is a generalized product life cycle,
4. When establishing the product element of the marketing mix, a company must decide its product mix, product line, and breadth and depth.
3. Consumer goods can be differentiated by the amount of effort and manner of search the consumer uses in purchasing the product.Industrial goods are classified as either production or support.
2. Consistency has multiple dimensions:consumer-journey consistency, emotional consistency, and communication consistency, which makes achieving this attribute challenging for services. In services,
1. Products and services differ in terms of tangibility. Services can also be distinguished by the Five I’s: intangibility, inconsistency, inseparability, inventory, and interaction.
Recognize the challenges in getting a new service or technology adopted in the market
Appreciate brand architecture for an organization and the alternative branding strategies
Identify the strategy considerations over the product life cycle
Understand the issues of product line formation
Learn the range of product and service variations
Understand the unique nature of services and the Five I’s to consider in service delivery
6. Under the Affordable Care Act, a healthcare organization was responsible for and would be rewarded or penalized based on how well it managed the health of a group of patients who were assigned to
5. The chief marketing officer (CMO) was meeting on the budget for the department with the chief financial officer (CFO) of the hospital.The line item of digital expenditures came up as the CFO
4. In the digital age, companies like Wayfair, Amazon, and others operate 24/7/365. How does a people-based industry such as healthcare, which has an inseparability between providing the service and
3. The adoption of RPM technologies faces significant barriers. As you review those barriers, assume you were the marketing director of a major RPM manufacturer addressing the national sales meeting
2. Assume you are the marketing director of the following type of companies involved with apps for different stages of the patient journey.Identify your primary target market, your rationale, and how
1. The Radnor Pediatric Care group has grown dramatically in recent years. Located in a midsized city in the Southeast that had seen an influx of younger families, the practice had recruited
9. The Internet of Things moves the healthcare ecosystem from a siloed setting of care solutions to an interconnected world of devices, technologies, and providers who can have access to devices,
8. Beyond the patient journey, the digital age poses unique challenges to the healthcare marketer in the form of an empowered consumer, a 365/24/7 world for the marketplace, an interconnected
7. With improvement in reimbursement for clinicians to monitor patients through RPM technologies, there is greater likelihood that RPM will see greater diffusion in the healthcare ecosystem. From a
6. Apps are now appearing that advance the applications of AI and are beginning to move into the process of clinical sites to improve patient flow for clinical care.
5. Increasingly, technology is allowing the consumer to receive a diagnosis online with technology and mobile assisted devices. In addition, capitalizing on the value of crowdsourcing, online sites
4. Almost two-thirds of individuals who go online for healthcare issues are searching for a specific health-related symptom or problem. In the digital environment, this shows that search-engine
3. The patient journey has changed dramatically in the digital environment, with each step impacted by digital technology and AI. In the wellness and prevention step of the journey, however, it is
2. The digital impact on healthcare marketing will require an increased realization that consumers increasingly live in a 365/24/7 environment. These individuals will demand greater transparency and
1. The digital impact has led to a transformation across industries and is impacting health care with new alternatives appearing online and with an array of mobile alternatives. These new forms

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