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Assessment description
The Patient Protection and Affordable Care Act of 2010 has imposed significant change
on healthcare in the United States by mandating the three underlying factors of the
act—access, quality and cost. These mandates are already impacting reimbursement
methodologies through bundled payments and pay­for­performance. Also, new delivery
models are evolving through this act, e.g., accountable care organizations (ACOs), which
are forcing mergers, acquisitions, and closing of healthcare organizations.
You are the CEO of the Downtown Medical Center, which is a 350­bed not­for­profit
community inner city facility with associated outpatient clinics. The facility and clinics
employ 1,196 professional, clerical, and other support staff. The community served is
mixed, including indigents and young professionals moving back to the urban lifestyle.
The facility is currently experiencing financial difficulties and must quickly make some
strategic decisions.
Given the incredible downsizing and rightsizing now facing healthcare organizations,
how would you decide where to “cut and become more lean” (if necessary) to
compete? Is it ethical to make these decisions without engaging stakeholders and
communicating senior management’s intentions to them?
You are to write an executive brief (two to three pages) supporting an ethical position
either pro or anti related to the scenario posed above.
● Format paper and cite references according to APA Style.
● Include a minimum of four credible reference sources.

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