Hospital Downsizing: Rural Hospital Closures, Impact of Managed Care, Changes in Reimbursement (Coursework Sample)

Hospital Downsizing
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Downsizing is the act of reduction, dismissal of personnel from work majorly by companies in order to reduce on the operating cost of the company. All through the United States hospitals have been the key contribution to health care delivery. However, there reached a period that the hospitals in United States have practiced downsizing in order to reduce cost and to evaluate the efficacy and proficiency of various utilities and processes. Despite the fact that downsizing as a process alienate employees in the health sector, studies report that this managerial strategy has had insignificant impact on access to services, care quality and the aptitude to reduce on cost. There are three major forces which were responsible for the downsizing of workforce in the hospitals. These factors included rural hospital closures, the impact of managed care and changes in reimbursement. These factors have each significantly contributed to the reduction of inpatient hospital utilization.
Rural Hospital Closures
Rural hospitals are commonly not located in a metropolitan county and they are normally short-term. The closure of most rural hospitals took place since the recession between 2008 and 2009. The factors that contributed to closure of hospitals in the rural areas include failure of the hospitals to recover from recession, decreased demand of inpatient services, and emergence of new models of care, population demographic trends and market trends (Shi & Singh, 2015). Some rural hospitals closed down due to uninsured patients as well as diminishing payments from Medicare. The payment reduction had a significant effect due to the previous agreement most hospitals made when the Affordable Care Act was created.
The inpatient utilization has reduced significantly as the rural hospitals cannot afford offering services to the patients who in most instances happen to lack insurances cover. The inpatient utilization has declined across all ages. However, most of the population who are 65 years and above have not reduced on the use of hospital facilities as their medical bills have been covered by Medicare (Duffield, Kearin, Johnston & Leonard, 2006).
Impact of Managed Care
Where and how healthcare is being delivered has been an issue of concern within the United States since the 1990s. Major closure and shifting of health care trend in hospitals have taken place in the past. Managed care in simple terms refers to the linking of the financing of the healthcare and the delivery of the healthcare services. Rapid and continued growth of managed care in the United States has as a result led to the downsizing of the hospital staff members (Duffield, Kearin, Johnston & Leonard, 2006). The development of better and improved ways of proper healthcare has resulted into the reduction of employee services which are no longer needed within the hospital facilities.
Better structural changes which have resulted in to the improvement of the patient management care have recently resulted into the reduction of nationwide inpatient rate of use within the United States. This can be attributed to the extreme research done which as a result has led to the proper outpatient care which has potentially prevented the need for hospitalization. On the same point, proper and well skilled outpatient care and treatment has also prevented complication or advancement of diseases hence no need for inpatient admission (Chadwick, Hunter & Walston, 2003). There has been a reduction in the ambulatory care sensitive admission has also been a factor which has indicated the better job done by hospitals in managing patients in order to prevent advancement of diseases to severe conditions.
Changes in Reimbursement
Lower reimbursement is a major contributing factor to the major layoffs and downsizing made in hospitals across the United States. The economy and the turmoil in Medicare and the operated Medicaid programs organized by the state were core contributing factors to the reduction of the hospital workforce (Shi & Singh, 2015). There were changes in the national policy healthcare offered unprecedented challenges to the hospital facilities resulting in reduced payment and increase in debts.
However, most hospitals have since been keen in ensuring that the services and quality of care they offer to their patients have not been impacted by the layoffs and as result have been cautious in laying off of those who work in the healthcare department (Chadwick, Hunter & Walston, 2003). The action which had been...