The Effect of Healthcare Reform on the Sustainability of Nonprofit Hospitals

Healthcare spending in the United States has continued to rise with annual healthcare cost of $3.8 trillion in 2014. While costs and the population continue to rise, resources continue to dwindle. Consequently, Congress has imposed various price controls and healthcare reform measures over the past 20 years, including the recent Patient Protection and Affordable Care Act (PPACA), which aims to decrease spending while enhancing quality and safety of care delivery. As a result of the implementation of the PPACA, 34 million additional Americans may be eligible for healthcare in a system already needing additional resources, increased access to care, and strategies to offset increasing operational and fiscal challenges. The purpose of this descriptive study was to explore what strategies and changes 10 executive leaders of the nonprofit hospitals in Maryland used to address the operational and fiscal challenges of the PPACA. The conceptual framework for this study was built upon the general systems theory. The data were collected through semistructured interviews, cataloged and coded, analyzed using a modified van Kaam method, and reviewed by participants as part of member checking process. The findings revealed 3 emergent themes: investment in IT resources to support an EMR system, strategies to address healthcare workforce challenges, and strategies for sustainability for managed care outpatient services and patient safety and quality of care. The findings impact social change by presenting policies and processes that medical professionals can use to support local and national health care reform. The Effect of Healthcare Reform on the Sustainability of Nonprofit Hospitals by Carmela J. Lynch MA, College of Notre Dame of Maryland, 1991 BSN, College of Notre Dame of Maryland, 1981 Doctoral Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Business Administration Walden University February 2016 Dedication I dedicate this work to my colleagues in healthcare who continue to pursue tirelessly and diligently delivering safe, quality care to the millions of people seeking relief from disease and other medically related issues. Acknowledgments I wish to extend thanks first to my God for the grace and blessings granted to me in pursuit of this goal, and especially for the wisdom of the Holy Spirit in enlightening my mind. Secondly, I wish to extend thanks to my wonderful and forgiving husband and children who have supported me without question or complaint throughout this journey and the juggling of life’s circumstances to make this journey’s end a prized reality. I wish to extend further thanks to Dr. Peter Anthony, my Chairman, for his excellent wisdom and guidance; Drs. Gossett and Szostek, committee members; Drs. Berete and Weide for their editing expertise and sincere concern for student success; and my special friends who have endured my missing many enjoyable moments in their company and remain my friends. Special thanks to Dr. Jennifer Arfaa and Dr. Ruth Lee for their encouragement, assistance, and understanding of the difficulties associated with this journey. Their consistent support and leading by example have provided the best incentive for my purpose in attaining this coveted goal. Last, but far from least, I wish to extend my heartfelt thanks to my dear friends, Patty and Bill Chmielewski, and my niece, Jessica, for lending their computer expertise, patience, and time in resolving many technical issues I encountered with each revision made during the preparation of this Doctoral Study.