HOSPITAL ORGANIZATIONAL STRUCTURE:
  Governing board (board of trustees): fiduciary oversight, strategic direction
  Medical staff (physicians): credentialing, peer review, bylaws
  Administration (CEO, CFO, CNO, CMO, COO): operations

  Medical staff types:
    Active: full privileges, attend/participate in governance
    Associate: provisional, privileges limited
    Honorary: emeritus, consulting only
    Consulting: episodic, specific cases

VALUE-BASED CARE PROGRAMS (CMS):
  MIPS (Merit-based Incentive Payment System):
    Quality, promoting interoperability, improvement activities, cost
    Score 0-100, affects Medicare payment +/-9%
  APMs (Alternative Payment Models):
    ACO (Accountable Care Organization): shared savings if hit quality/cost targets
    BPCI Advanced: bundled payments for specific episodes
    Primary Care First: prospective payment for primary care

HEALTHCARE MERGERS AND ACQUISITIONS:
  CON (Certificate of Need): state permission required for new facilities/services
  Due diligence: financial, operational, legal, cultural assessment
  Integration challenges: EHR consolidation, culture, staff retention
  FTC review: antitrust concerns in concentrated markets

POPULATION HEALTH MANAGEMENT:
  Risk stratification: identify high-risk patients for intervention
  Care coordination: nurses, social workers, pharmacists working together
  Social determinants of health (SDOH): housing, food, transportation
  Attribution: assign patients to primary care providers for accountability

EHR SYSTEMS:
  Epic: largest market share in hospitals (60%+)
  Cerner (Oracle): second largest, strong in community hospitals
  MEDITECH: strong in critical access and community hospitals
  Allscripts, athenahealth: ambulatory/physician office

  Meaningful Use / Promoting Interoperability:
    CMS incentive program for EHR adoption and use
    Requirements: patient access to records, e-prescribing, CPOE, HIE

  FHIR (Fast Healthcare Interoperability Resources):
    Standard for health data exchange (HL7 FHIR R4)
    APIs for patient data access (21st Century Cures Act requirement)
    SMART on FHIR: apps that integrate with EHRs

REVENUE CYCLE TECHNOLOGY:
  RCM platforms: Waystar, Experian Health, Optum360
  Claims scrubbing: catches errors before submission
  AI denials prediction: identify likely denials before billing
  Patient engagement: online scheduling, bill pay, secure messaging

HEALTH INFORMATION EXCHANGE (HIE):
  CommonWell, Carequality: national interoperability networks
  Epic Care Everywhere: Epic-to-Epic sharing
  State HIEs: regional infrastructure
  Blocking information: illegal under 21st Century Cures Act (info blocking)