Americans spent nearly $2.6 trillion, or $8,000 per person for medical and administrative costs in 2010. By 2015, healthcare spending in the United States increased to 5.8% reaching $3.2 trillion or $9,990 per individual. By tackling healthcare administrative costs, it is estimated that healthcare providers could reduce these costs by $20 billion yearly. This case study explored strategies for streamlining hospital administrative procedures to reduce costs. The business process reengineering model formed the conceptual framework for this study. Data were gathered through semistructured face-to-face interviews guided by open-ended questions with a purposeful sample of 4 hospital managers in Atlanta, Georgia. This study identifies important themes regarding cost reduction and hospital administration based on participant interviews. Themes included participants' unfavorable perspectives of the Spell out PPACA (PPACA) legislation, employment of physicians, PPACA reimbursement method, follow-up services, hospital administrative governance, and lack of business education. The themes comprised steps hospital managers could take to streamline administrative procedures to reduce costs. The implications for positive social change included the potential to provide strategies for streamlined processes that could lead to savings passed on to patients from low socio-economic backgrounds through accessibility to affordable healthcare services.

The focus of this research was to investigate the use of a district created formative benchmark assessment in reading to predict student achievement for 10th-grade students on the Florida Comprehensive Assessment Test (FCAT) in one county in north central Florida. The purpose of the study was to provide information to high school principals and teachers to better understand how students were performing and learning and to maximize use of the formative district benchmark assessment in order to modify instruction and positively impact student achievement. This study expanded a prior limited study which correlated district benchmark assessment scores to FCAT scores for students in grades three through five in five elementary schools in the targeted county. The high correlations suggested further study. This research focused on secondary reading, specifically in 10th grade where both state and targeted county FCAT scores were low in years preceding this research. Investigated were (a) the district formative assessment in reading as a predictor of FCAT Reading scores, (b) differences in strength of correlation and prediction among student subgroups and between high schools, and (c) any relationships between reading formative assessment scores and Mathematics FCAT scores. An additional focus of this study was to determine best leadership practices in schools where there were the highest correlations between the formative assessment and FCAT Reading scores. Research on best practices was reviewed, and principals were interviewed to determine trends and themes in practice. Tenth grade students in the seven Florida targeted district high schools were included in the study. The findings of the study supported the effective use of formative assessments both in instruction and as predictors of students' performance on the FCAT. The results of the study also showed a significant correlation between performance on the reading formative assessment and performance on FCAT Mathematics. The data indicated no significant differences in the strength of correlation between student subgroups or between the high schools included in the study. Additionally, the practices of effective principals in using formative assessment data to inform instruction, gathered through personal interviews, were documented and described.