Refer to the "Metropolis Health System" case study which is below. Specifically go to "background item #11" ("Planning the Future for MHS)--. By implementing the "5 areas of desired service and programmatic enhancement", what financial issues would you anticipate and how would you address each one?

In each of the 5 areas what financial issues would you anticipate and how would you address or deal with each one.

Background

1 Hospital System

Metropolis Health System (MHS) offers comprehensive healthcare services. Its a midsize taxing district hospital. Although MHS has the power to raise revenues through taxes, it has not done so for the past seven years.

2 The Area

MHS is located in the town of Metropolis, which has a population of 50,000. The town has a small college and a modest number of environmentally clean industries.

3 MHS Services

MHS has taken significant steps to reduce hospital stays. It has developed a comprehensive array of services that are accessible, cost-effective, and responsive to the communitys needs. These services are wellness oriented in that they strive for prevention rather than treatment. As a result of these steps, inpatient visits have increased overall by only 1,000 per year since 1998, whereas outpatient/same day visits have had an increase of over 50,000 per year.

A number of programmatic, service, and facility enhancements support this major transition in the communitys institutional healthcare. They are geared to provide the quality, convenience, affordability, and personal care that best suit the health needs of the people whom MHS serves.

Rehabilitation and Wellness Center- for outpatient physical therapy and return-to-work services, plus cardiac and pulmonary rehabilitation, to get people back to a normal way of living.

Home Health Services-bringing skilled care, therapy, and medical social services into the home; a comfortable and affordable alternative in longer-term care.

Same-Day surgery (SDS)-eliminating the need for an overnight stay. Since 1998, same-day surgery procedures have doubled at MHS.

Skilled Nursing Facility- inpatient service to assist patients in returning more fully to an independent lifestyle.

Community Health and Wellness- community health outreach programs that provide educational seminars on a variety of health issues, a diabetes education center, support services, for patients with cancer, health awareness events, and a womans health resource center.

4 MHS Plant

The central building for the hospital is in the center of a two square block area. A physicians office building is to the west. Two administrative offices, converted from former residences, are on one corner. The new ambulatory center, completed two years ago, has an L shape and sits on one corner of the western block. A laundry and maintenance building sits on the extreme back of the property. A four story parking garage is located on the eastern back corner. An employee parking lot sits beside the laundry and maintenance building. Visitor parking lots fill the front eastern portion of the property. A helipad is on the extreme western edge of the property behind the physicians office building.

5 MHS Board of Trustees

Eight local community leaders who bring diverse skills to the board govern MHS. The trustees generously volunteer their time to plan the strategic direction of MHS, thus ensuring the systems ability to provide quality comprehensive healthcare to the community.

6 MHS Management

A chief executive officer manages MHS. Seven senior vice presidents report to the CEO. MHS is organized into 23 major responsibility centers.

7 MHS Employees

All 500 team members employed by MHS are integral to achieving that high standards for which the system strives. The quality improvement program, reviewed and reestablished in 2005, is aimed at meeting client needs sooner, better, and more cost-effectively. Participants in the program are from all areas of the system.

8 MHS Physicians

The MHS medical staff is a key part of MHSs ability to provide excellence in healthcare. Over 75 physicians cover more than 30 medical specialties. The high quality of their training and their commitment to the practice of medicine are great assets to the health of the community.

The physicians are very much a part of MHSs drive for continual improvement on the quality of healthcare services offered in the community. NHS brings in medical experts from around the country to provide training in the new techniques, made possible by MHSs technologic advancements. MHS also ensures that physicians are offered seminars, symposiums, and continuing education programs that permit them to remain current with changes in the medical field. The medical staff s quality improvement program has begun a care path initiative to track effective means for diagnosis, treatment, and follow-up. The initiative will help avoid unnecessary or duplicate use of expensive medications or technologies.

9 MHS foundation

Metropolis Health Foundation is presently being created to serve as the philanthropic arm of MHS. It will operate in a separate corporation governed by a board of 12 communities leaders and supported by a 15 member special events board. This mission is the foundation will be to secure financial and non-financial support for realizing the MHS vision of providing comprehensive healthcare for the community. Funds donated by individuals, businesses, foundations, and organizations will be designated for a variety of purposes at MHS, including the operation of specific departments, community outreach programs, continuing education for employees, endowments, equipment and capital improvements.

10 MHS Volunteer Auxiliary

There are 500 volunteers who provide over 60,000 hours of service to MHS each year. These men and women assist in virtually every part of the systems operations. They also conduct community programs on behalf of MHS. The auxiliary funds its programs and makes financial contributions to MHS through money it raises on renting televisions and vending gifts and other items at the hospital. In the past, its donations to MHS have generally been designated for medical equipment purchases. The auxiliary has given $250,000 over the last 5 years.

11 Planning the Future for MHS

The MHS has identified 5 areas of desired service and programmatic enhancement in its five year strategic plan:

Ambulatory Services

Physical Medicine and Rehabilitative Services

Cardiovascular Services

Oncology Services

Community Health Services

MHS has set out to answer the most critical health needs that are specific to its community. Over the next five years, the MHS strategic plan will continue a tradition of quality, community-oriented health care to meet future demands.

12 Financing the Future

MHS has established a corporate depreciation fund. The funds purpose is to ease the financial burden of replacing fixed assets. Presently, it has almost $2 million for needed equipment and renovations.