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Dramatic changes in the U.S. healthcare environment, involving aspects like the production of basic healthcare, research, funding and the creation of large, vertically integrated health care networks, necessitated some changes in the hospitals way of doing things. One of the most affected hospitals were the BWH, Brigham Women’s Hospital and the MGH, Massachusetts General Hospital. The problems they encountered and recommended solutions are as follows;

Funding

Situation

Reduction in revenues from the largest payer source the Medicare Program was anticipated. There was also reduced government support for the various hospital programs. Enactment of Chapter 495 on the aspect of funding also affected other sources of patient service revenue.

Problem

This was a big blow to the hospitals since this funding is what they depended on for the various research and teaching projects. It was also needed for the purchase of other facilities in the hospital such as beds that were urgently needed to take care of the increase in the number of patients.

Analysis

A quick solution had to be found out to see to it that the hospitals got an alternative source of funding to ensure its continued effective offering of services. This was not easy with the increase in number of patients with each passing day. The government should also have seen the damage it was creating with the lessened support and act accordingly.

Recommendation

New contracts should be secured with other insurers, managed care plans and the Commonwealths Medicaid Programs. This would ensure the hospitals get the necessary funding for effective running.

Research

Situation

BWH was known for its world class clinical research. This was used in areas such as hematology, cardiology, endocrinology, neurology and pharmacology. Research grants and contracts paid for the salaries of the various employees as well as the cost of equipment, supplies and indirect overhead costs of the laboratories.

Problem

BWH did not cover the funding of the research by itself. However, there was a reduced support of funding from the government and also the other supporters the Medicare and Medicaid withdrew their funding aid.

Analysis

An alternative means of funding had to be found instantly to support the research activities to ensure that the hospitals continued to explore and come up with helpful discoveries. Other sources of funding had to be found.

Recommendation

Research contracts had to be set up with private corporations. Extra support from the government could be sourced out and also some percentage from the clinical revenues could be channeled to the research funding.

Clinical Care

Situation

BWH and MGH provided an array of primary and secondary care to its area residents. They also provided advanced specialty services in Boston and neighborhoods. This earned the hospital a worldwide reputation for medical excellence and specialized services.

Problem

As a result of the excellent services, the hospital received an annual growth rate of 2.1% for in patient admission. There was a problem since the hospital was not braced with the handling of the large number of patients. The bed capacity became a problem too as the patients were many especially cases that required admission. All of them could not be accommodated due to the limited space.

Analysis

There was a need to enroll more staff to alleviate the situation. Salaries too had to be looked at to ensure great motivation for the physicians who had the likelihood of having to work for many hours to ensure that everyone was taken care of.

Recommendation

Highly capable physicians to be recruited to encourage a high level team work and collaboration. Collaboration with other hospitals would ensure that exchange programs with the nurses helping out during their off periods to ensure that all the patients are well catered for. Extra funding would have to be looked for to increase the bed facilities available.

These were the various problems facing the BWH and MGH and the recommendations that could be put in place to take care of the problems that were being encountered. A merge between the two hospitals may help to lessen the problems and would benefit both the institutions.

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