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Although it was considered so terrible it was never going to happen, Sequestration is here. Hospitals are faced with absorbing a 2% reduction in Medicare reimbursement. For some hospitals this can amount to hundreds of thousands of dollars per year. Add to this change Value-based Purchasing, Readmission Penalties, reductions in DSH and UPL payments, increased RAC Reviews and hospitals across the country are facing an uphill climb. This puts a tremendous strain on all hospitals, even those with tax support.
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CEOs continue to express concerns about how they can maintain financial performance in the current economic climate. Nationally, hospital census numbers have declined. Medicare has implemented a 2% reduction in payments and many state Medicaid plans have reduced reimbursement rates. Lower volumes and decreased reimbursements have hit the hospital industry hard. Proactive C-suite staff members are modeling possible solutions. One common solution is to project increased revenues through new service lines to offset the lower reimbursements. A few have considered cost cutting as the best path for their organization. Both methods can work but some are harder to achieve than others.
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These are simplified slides discussing the regulation of cardiac output and venous return. Learning objectives: 1. Comprehend the determinants of cardiac output and factors affecting cardiac output 2. Comprehend the factors affecting stroke volume and heart rate and total peripheral resistance 3. Identify the factors regulating venous return 4. Discuss the causes of high and low output cardiac failure 5. Enlist the functions of veins and recognise the significance of venous reservoirs Study Resources: 1. Chapter 20, Guyton and Hall Textbook of Medical Physiology, 14th edition 2. Chapter 30 and 32, Ganong’s Review of Medical Physiology, 26th edition 3. Chapter 10, Human Physiology by Lauralee Sherwood, 9th edition 4. Physiology, Cardiac Output - StatPearls https://www.ncbi.nlm.nih.gov/books/NBK470455/
Cardiac Output, Venous Return, and Their Regulation
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