USA: +1(669)289-8683 
Sign in
APA
300words
1 references
grammar and plag checked
6hrs only
|
Discussion question |
What are the significant barriers in obtaining and maintaining peer relationships for students with physical and health impairment? How can teachers facilitate these relationships?
Running head: John hopkins financial 1
John hopkins financial 12
John Hopkins Financial Analysis
jjjjjjjjjj
xxxxxxx
x
xxxxxxx
xxxxxxxx
April 28, 2018
Contents
General Background……………………………………..………………………………………3
Issues/Problems Identified……………………………………………………………………….4
Analysis of ratios and other Financial Analysis tools….………………………………………5
Recommendations………….………………………………………………………………..…6-7
Implementation Plans.……………………………………………………………………………8
Monitoring Methodology……………………….………………………………………………..9
References……………………….……………………………………………………………….10
Background
The start of this prestigious hospital dates to the late 1800’s when a wealthy Quaker philanthropist Johns Hopkins passed away. In his will, Johns Hopkins left seven million dollars to the start of a free hospital and medical colleges for the area of Baltimore, Maryland. Centuries later, Johns Hopkins Hospital is ranked in the top five hospitals in the nation. JHH serves as a leader in biomedical research, education, and treatment for the United States of America.
Johns Hopkins Hospital has evolved to become a complex system with six different hospitals, numerous healthcare sites, and four surgery centers in different locations of the USA.
Issues / Problems Identified
An analysis of John Hopkins Health System was done using several key ratios. This case study will identify the key problems. It will also suggest solutions to the problems, an implementation plan,and monitoring methodology.
According to the text,the total margin is the net income divided by the total revenues it is important because it provides a measure of a hospitals overall profitability. Analysts at the primary measure of a hospitals profitability. The industry average for total margin is 5%. According to the 2017 annual report, John Hopkins Health had a total profit margin of 2.9%. In comparison, UMass Memorial Health was 2.8. Both systems were lower than the industry average.(1)
The operating margin is the operating income divided by the total operating revenues. The industry average operating margin is 3.5%. John Hopkins Health 2017 operating margin was 2.5%. UMass Health had a slightly lower operating margin of 1.7%.
The Return of assets is the net income divided by the total assets. The ROA tells managers how productively, in a financial sense, a business is using its assets. The higher the ROA, the greater the net income on each dollar invested in assets and hence the more productive the assets. The industry average is 4.8%. John Hopkins Health 2017 ROA was 3.7, which was lower than the industry average. UMass Health was also lower at 2.7.
The return of equity is net income divided by the total equity. In a not-for-profit, the ROE is used to determine how well, in financial terms, its community supplied capital isused. The industry average for Return of Equity (ROE) is 8.4 percent. John Hopkins health had a 4.3 percent return of equity, which was lower than the industry average. Umass Health had a 6.9 percent (ROE) which was slightly better than JHHS, but still lower than the industry average.
Analysis Utilizing ratios and Financial Analysis tools
Ratio John Hopkins UMASS Health Industry Average
Total Margin 2.9% 2.8% 5.0%
Operating Margin 2.5% 1.7% 3.5%
Return on assets 3.7% 2.7% 4.8%
Return on Equity 4.3% 6.9% 8.4%Current Ratio 1.9% 1.7% 2.0%Day-Cash-on-Hand 808 days 41 days 31 days
Debt-to-Equity 53% 40% 73%
Recommendations:
Further analysis is required beyond the review of the financial data to identify opportunities for increased revenues as well as cost avoidance. Deeper dives into the coding and billing processes, denial rate, as well as standardization of supplies to identify if there are other avenues to increase revenue. According to the Advisory Board (2017) the average hospital has lost close to one million dollars net revenue loss over the past four years due to penalties from pay for performance (P4P). The Advisory Board also noted in 2016 that hospitals and health systems showed significant weekend margins for the first time since 2012. Hospitals must define and implement a multi-year margin strategy. While in previous years volume and price growth was enough to sustain margin weakness, it does not appear that this will be the answer to the problem. Hospitals must prioritize and focus on cost containment as the key strategy to strengthen margins. According to the Advisory Board (2016) organization-specific financial, operational and quality data must be benchmarked to tailor margin strategy. It is essential for hospitals to know their performance data and benchmark themselves to local competitors and “like” hospitals across the country.
Total Margin: (**increase collections/ increase successful appeals**)
We would recommend that John Hopkins expand their ambulatory and long-term care to manage populations within their networks.They should join the network that is managing their dollar, there are opportunities for financial growth, delivering the right diagnosis and treatment at the right time; this includes making sure patients receive the right medications and nurses are moving patients through the hospital and educating them about their medication regimen before discharge.
Operating Margin: (**increase collections/ increase successful appeals**)
We would recommend workforce reduction (primarily in non-patient care areas), management restructuring and flattening benefit changes, and an examination of operations and the way work is done. Every aspect of support services would be analyzed, including opportunities to consolidate service contracts, consolidate programs, streamline vendor relationships, improve supply chain, and cut waste.
Return on Assets: (assets=equipment, property, receivables, land. Reduce what is owed**)
We would recommend instituting an enterprise asset management (EAM)program. EAM is management of an enterprise’s assets across all departments, facilities, business units and geographical locations. EAM integrates techniques for holistic control and optimization throughout those assets’ varying lifecycles. It brings together planning, acquisition, commissioning, operations and eventual replacement.
Once implemented, EAM’s benefits are substantial. A successful EAM program could save John Hopkins between 5 and 20 percent in annual capital equipment purchases.
Return on Equity (**increase revenue, decrease costs**)
We would recommend increasing the return on equity by reducing overall costs.
An example of this would be to reduce or eliminate unnecessary tests in a way that does not shortchange or endanger the patients. Reducing length of stay can be done through preventing errors that would extend a stay or delay a discharge when patients are medically ready to go home. Because of miscommunication, poor planning, or when families or nursing homes are not yet ready to take on the person that is being discharged, a four-day stay can suddenly turn into a five- or six-day stay. These process-related things are not medical issues, but they often extend length of stay which can cost millions.
Implementation Plans
Consider revenue integrity specialist to identify if coding/billing is optimal. Improved MD documentation will lead to increased DRG reimbursement and appropriately capture MCCs→ can be reflected in risk-adjusted quality data. Standardizations of practice and order-sets will decrease variability. Ensure that all supplies are on the HPG contracts so that costs will be the lowest possible. Monitor supply utilization & partner with MDs and Clinical staff to reduce waste. Hire inventory supply (materials management) specialists to monitor supply utilization and limit who can order supplies.
increase point of service cash collections, even collecting twenty dollars per patient at the time of the visit will increase revenue.
Monitoring Methodology
(**internal benchmarks to gauge performance**)
· comparing JH to itself throughout the quarters and against comparable hospitals.
References
1.
https://www.hopkinsmedicine.org/about/downloads/jhm-brief
2.
https://emma.msrb.org/ER1106106-ER865043-
3.
http://www.hscrc.state.md.us/Documents/Hospitals/ReportsFinancial/Audited/fy-2014/0009_JHH_AFS_FY14
4.
https://www.hopkinsmedicine.org/about/index.html
5.
http://nonprofits.findthecompany.com/l/422333/The-Johns-Hopkins-Hospital
6.
http://brand.hopkinsmedicine.org/gui/content.asp?w=pages&r=5&pid=186
7.
https://www.beckershospitalreview.com/hospital-management-administration/massachusetts-general-vs-johns-hopkins-6-key-comparisons.html
8.
https://www.beckershospitalreview.com/finance/40-financial-benchmarks-for-hospital-executives-august11.html
