Biomedical subjects

Thomas P Weil

Publications and source records attributed to Thomas P Weil.

8 recordsLinked to original sources

PubMed2005

Leadership development in MHA programs: a response and commentary.

The transformation of healthcare from a relatively sheltered sector of the economy into one characterized by market competition and volatility has tested the values, abilities, and leadership strategies of healthcare executives. Changes in the scale and complexity of healthcare organizations and in provider reimbursement impose demands on executives that bear little resemblance to those of the past. In light of these challenges, health management programs are reassessing their responsibilities and capacities in the preparation of MHA graduates. Unfortunately, there is a lack of consensus on how students should be trained, advised, and mentored for leadership responsibilities. In our view, MHA programs can begin to address this problem through support of a balanced normative model for leadership training whereby classroom immersion in academic subjects is complemented by exposure to practice and experience. This model must be value-oriented, balancing business imperatives with traditional service ideals, and reality-oriented, balancing the teaching methods of theory and practice. In our view, MHA programs can begin to adapt to this model though student selection, curriculum reform, and involvement by practitioners and alumni.

Education, Graduate↗

PubMed2003

Hospital downsizing and workforce reduction strategies: some inner workings.

Downsizing, manpower reductions, re-engineering, and resizing are used extensively in the United States to reduce cost and to evaluate the effectiveness and efficiency of various functions and processes. Published studies report that these managerial strategies result in a minimal impact on access to services, quality of care, and the ability to reduce costs. But, these approaches certainly alienate employees. These findings are usually explained by the significant difficulties experienced in eliminating nursing and other similar direct patient care-oriented positions and in terminating white-collar employees. Possibly an equally plausible reason why hospitals and physician practices react so poorly to these management strategies is their cost structure-high fixed (85%) and low variable (15%)-and that simply generating greater volume does not necessarily achieve economies of scale. More workable alternatives for health executives to effectuate cost reductions consist of simplifying prepayment, decreasing the overall availability and centralizing tertiary services at academic health centres, and closing superfluous hospitals and other health facilities. America's pluralistic values and these proposals having serious political repercussions for health executives and elected officials often present serious barriers in their implementation.

Attitude of Health Personnel↗

PubMed2002

Multispecialty physician practices: fixed and variable costs, and economies of scale.

Medical Group Management Association survey data from 1955 to 1999 was to assess fixed compared to variable cost and the existence of economies of scale among single- and multispecialty groups. During these intervening 44 years, physician operating costs were estimated to increase roughly three times the consumer price index. Among the multispecialty groups in 1999 at least 85% of total medical revenues were considered fixed costs when including a physician's compensation and fringe benefits. On the basis of relative value units (RVUs), 10 practitioners provided the maximum economies of scale. However, for multispecialty groups, based on a physician's total compensation, optimal efficiency occurred between 26 and 50 doctors. Those multispecialty practices with 51 or more MDs are thought to be "less efficient" for several reasons: they deliver care on multisites, experience a higher percentage of managed care patients, and are less effective in controlling their peers' use of time and resources.

Costs and Cost Analysis↗

PubMed2002

Eliminating fixed costs: Part I--Health system drivers.

Americans want less-bureaucratic, higher-quality, and above all, less-costly health care. Reducing the number of nurses, pharmacists, and others who care for patients is not a viable solution; fiscal constraints, which reduce fixed costs, are superior to other options in containing health costs. To this end, it is imperative that the U.S. reimbursement system be simplified. Posing as a major encumbrance are some deeply vested, highly placed self-interests that obstruct implementation of a partly private, partly public reimbursement system that would better serve patients, providers, and insurers. In part I of this two-part article, the author describes some of the drivers that are pushing health care costs to higher levels.

Cost Control↗

PubMed2002

Eliminating fixed costs: Part II--A pathway to reduced health expenditures.

The second half of this two-part article examines some potential solutions to offset the rise in health care expenditures that currently afflicts the United States. Among the ideas proposed by the author is an emphasis on changing reimbursement processes. In addition, he argues, eliminating one-half million bureaucratic jobs could reduce health expenditures by billions of dollars.

Budgets↗

PubMed2002

Managed competition using both market-driven and regulatory strategies.

The market-driven managed competition concept has been successful in reducing increases in healthcare costs by controlling utilization and price, but has failed to date to produce an effective and efficient delivery of health services. The proposed health reform plan calls for universal access (excluding illegal aliens), a relatively broad range of clinically effective basic benefits, an option to purchase supplementary benefits, a ceiling placed on the nation's total health expenditures, local decisionmakers allocating available resources, existing insurers administering the plan and providing consumers with additional quality of care comparisons.

Cost Control↗

PubMedDate not supplied

Governance in a period of strategic change in U.S. healthcare.

The increased enrollment in managed care plans, merger mania and the development of politically and financially powerful integrated delivery systems have significantly complicated the governance of U.S. healthcare organizations. These modifications in fiscal incentives and the corporate restructuring undertaken by American health organizations has resulted in limited fiscal savings or improvements in access to care. As a result, trustees are now faced with divesting their losers, and shuttering facilities and services to reduce fixed costs. Decision-making by trustees will be further thwarted in the future by: their institutions being forced to deliver more care without a proportional increase in revenues; physicians seeking to obtain more ambulatory revenues at a hospital's expense; the inability to adequately finance mental health and long-term care services except among the wealthy; the number of divestitures increasing so that eventually the organizational focus for most IDSs will once again be on regionally oriented hospital systems; and much more difficulty being experienced in attracting sufficiently qualified personnel to deliver high quality health services. Finally, many of these findings relevant to the United States also are being shared by governing boards in Canada, Germany, The Netherlands and the United Kingdom.

Capital Expenditures↗

PubMedDate not supplied

Divesting losers: chipping away at integrated delivery systems.

Integrated health systems are rapidly divesting earlier acquisitions to beef up their bottom lines. Take an in-depth look at what the future may hold as the health systems battle to reorganize and reap greater profits.

Decision Making, Organizational↗