Reference no: EM133170131

Consider the following case: You have recently been appointed the chief strategy officer of a healthcare system called Carlaris Health. Carlaris owns seven hospitals in three states in the Midwest, and its revenue is $400 million annually. Government programs such as Medicare and Medicaid account for 70 percent of the revenue; the rest is from commercial contracts. Carlaris recently experienced a 25 percent drop in its admissions, in part because a larger health system started focusing on activity in Carlaris's area, causing many admissions to be diverted. Health plans and employers have expressed concern that Carlaris's cost structure is comparatively high, and a recent spate of infections and complications after surgeries has brought negative publicity.

The medical staff has had difficulty recruiting new physicians to the area because of low reimbursement, high workload, and poor collaboration between the physicians and the health system. Readmission rates have been rising, causing Carlaris to be penalized by Medicare. Many patients in the area lack adequate primary care, which results in them coming to the emergency room for health problems that could have been prevented. Safe discharges for these patients also pose a challenge. Your team has been tasked with producing a strategic plan that can put Carlaris on a steady financial and operational footing.

What steps can be taken to integrate Carlaris health system and the physicians?

Are interprofessional opportunities available to improve access to primary care?

How can interprofessional options be used to address high readmissions?

Carlaris Health has a presence in several geographic areas. Provide a strategy to take advantage of this presence through physician-hospital organizations, ACOs, and service line collaboration.

Can Carlaris Health become a payer as well? What are the benefits and risks of such a strategy?