HCM FPX 5314 Assessment 1 Aligning Strategic Initiatives to Goals

HCM FPX 5314 Assessment 1 Aligning Strategic Initiatives to Goals

Student Name

Capella University

HCM-FPX5314 Driving Health Care Results

Prof. Name:

Date

Organization Overview

Bismarck Evangelical Hospital, founded in 1902 in Bismarck, North Dakota, underwent a major upgrade in 1916, becoming a modern 58-bed facility. As the surrounding environment changed, the hospital began to focus on serving the impoverished community and later rebranded itself as Sanford Medical Center Bismarck. This new identity was marked by the construction of a 217-bed facility. Sanford Health’s system now includes a Level II trauma center, seven primary care clinics, three urgent care centers, four specialty clinics, three long-term care facilities, three kidney dialysis centers, three occupational health clinics, a health home agency, and one independent living center. The organization serves a diverse, family-oriented community experiencing growth due to the oil fields in western North Dakota. Sanford Health Bismarck currently employs over 3,600 people, including 260 physicians and advanced practitioners. The organization’s vision is to enhance the human condition at every life stage through exceptional care, spiritual enrichment, innovation, and discovery. Sanford Health is dedicated to diversity and inclusion, with its growth reflected in its expanding patient and employee base.

Strategic Initiative Analysis

Access to Healthcare

Access to healthcare is defined as the “timely use of personal health services to achieve the best health outcomes.” Ensuring affordable healthcare access is crucial for both physical and mental health and is a cornerstone of a successful healthcare organization. Health insurance plays a significant role in healthcare access. Individuals without insurance are less likely to seek medical treatment due to cost barriers. Sanford Bismarck Medical Center has implemented strategies to enhance healthcare access within the community. The first strategy involves partnering with a company that secures Medicaid coverage for uninsured patients based on income, with additional options to alleviate financial burdens for those who do not qualify. Sanford Health Bismarck also offers financial assistance for medically necessary services to either cover the outstanding balance or significantly reduce the bill.

The second strategy includes establishing urgent care centers within the community, which provide more affordable care and prevent unnecessary emergency room visits. An urgent care visit costs approximately $170, compared to an average emergency room visit cost of $2,000 (Kantor, 2019). Sanford is expanding these centers into rural areas to increase the availability of quality care. The third strategy focuses on effective communication to minimize care breakdowns and build trust between patients and physicians. Achieving optimal health outcomes depends on the patient’s trust and effective communication with their healthcare provider (Sanford Medical Center Bismarck, 2019).

Quality Services

Sanford Health offers a comprehensive range of services, but there is room for improvement in quality. Four committees are tasked with enhancing the quality of patient services. The Physician Quality Committee develops and enforces policies and procedures while evaluating program and service quality. The Pharmacy and Therapeutics Committee provides education to physicians and pharmacists to ensure the latest prescription information is up-to-date. The Health Plan Quality Improvement Committee reviews healthcare issues impacting patients and updates policies as necessary. The Credentialing Committee evaluates providers in the Sanford Health Plan network and addresses any quality deficiencies affecting patient welfare. These four committees are central to Sanford Health Bismarck’s quality services strategic initiative. Collaborative teamwork and effective communication within these committees aim to improve patient service quality and achieve the best outcomes (Sanford Medical Center Bismarck, 2019).

Cost-Effectiveness

As the largest rural healthcare system in the nation, Sanford Health has felt the impact of Medicare reimbursement cuts. Many rural hospitals depend on Medicare, which accounted for 46% of all gross revenue in 2016. Major reimbursement cuts can lead to higher prices and reduced revenue as hospitals are not compensated for the services provided. Changes in government regulations are unpredictable and challenging for hospitals to manage, complicating efforts to remain cost-effective (LaPointe, 2018). Sanford Health Bismarck charges less than the national average for inpatient and outpatient services while maintaining high-quality care. As part of the Commission on Cancer program, Sanford Health reports clinical data to measure performance. Out of ten performance measures, Sanford exceeds national standards in eight, demonstrating high-quality care. The shift towards value-based care is essential for providing affordable and effective care, focusing on patient outcomes and cost control.

Barriers to Access, Quality Services, and Cost-Effectiveness

Understanding barriers to healthcare is crucial for developing effective strategies. These barriers include high healthcare costs, lack of insurance, inadequate services, location issues, timeliness, lack of patient engagement, rising healthcare spending, new government regulations, reimbursement cuts, and insurance changes. These barriers can hinder the achievement of strategic goals by causing patients to delay seeking medical attention, leading to financial burdens, inadequate preventive services, and delays in coordinated care. Delays can increase patient anxiety, complications, treatment costs, and hospitalizations (Access to Health Services, n.d.). Identifying and addressing these barriers is essential for adapting to the evolving healthcare environment.

Evaluation of the Internal Structure of Sanford Health Bismarck

Evaluating Sanford Health Bismarck’s internal structure is crucial for developing strategic plans that adapt to changes. A SWOT analysis and a VRIO analysis can provide insights into the organization’s strategic and operational framework. SWOT analysis helps identify strengths, weaknesses, opportunities, and threats:

• Strengths: Highly trained staff, affordable high-quality care, a wide range of medical services, investment in new technology, and improved access to healthcare.
• Weaknesses: Small, outdated facility, inconsistent care due to communication gaps, nurse shortages, fewer staff members, and potential for culturally incompetent providers in North Dakota.
• Opportunities: New programs to increase care access, advancements in technology, improvements in outpatient care, better communication across the organization, and potential partnerships with other health centers.
• Threats: New competitors, economic and political changes, state and federal budget cuts, and high demand for costly medical equipment.

The VRIO framework assesses value, rarity, inimitability, and organization. Sanford Health provides value through its quality services and access initiatives. Its status as the largest rural hospital system makes it rare and inimitable. The organization’s clear initiatives and direction support well-informed decisions, ensuring long-term success.

Internal Structure Driving Results from a Strategic Perspective

Analyzing the internal structure’s ability to drive results strategically involves understanding strategy as a set of goal-directed actions to achieve superior performance (Rothaermel, 2017). Strategic objectives should transform mission and vision statements into actionable projects. For Sanford Health Bismarck, aligning internal structure with strategy is crucial for improving healthcare access and increasing patient awareness. Sanford’s internal structure supports its strategy of delivering affordable quality services and value-based care. Effective communication across disciplines integrates patient care and enhances results (Stowell & Akerman, 2015).

Internal Structure Driving Results from an Operational Perspective

Operational objectives are daily to monthly tasks designed to achieve strategic goals. Sanford Health Bismarck’s operations, including finance, logistics, marketing, sales, service, and IT, ensure the organization functions optimally. Effective operational management supports strategic positioning and helps deliver quality, value-based care.

Recommendations

Aligning organizational structure with customer-focused results involves fostering a collaborative environment. Collaboration develops emerging leaders, encourages critical thinking, and builds strong relationships. A collaborative culture leads to increased productivity and success (Gaskell, 2017). A customer-oriented approach influences strategic decisions, ensuring they focus on customer experience. Sanford Health Bismarck’s strategy centers on patient needs, as reflected in its mission and vision statements. Maintaining a value-based approach ensures high-quality care and aligns organizational structure with customer-focused results. Innovation and technology can further enhance care delivery and create opportunities for Sanford Health (Craig, 2018).

Value-Based Purchasing Models

Historically, hospitals used fee-for-service models, which incentivized quantity over quality. This approach contributed to high healthcare costs. The transition to value-based care focuses on quality and cost control. The Centers for Medicare & Medicaid Services (CMS) established four domains for incentive payments, with penalties for non-compliance. The domains are Patient and Caregiver-Centered Experience of Care/Care Coordination, Safety, Clinical Care, and Efficiency and Cost Reduction (Brown, 2018).

Value-Based Purchasing Influence on Healthcare Management

The value-based model pressures healthcare organizations to improve performance and patient outcomes. Managers must make informed decisions on budgeting, policy, regulations, patient care, and other areas while following CMS guidelines. Effective decision-making and collaboration are essential for managing the transition from fee-for-service to value-based models (Damberg et al., 2014).

Shared Risk Models

Shared risk models involve providers taking on financial risk with potential rewards. Providers share savings with insurance companies if they reduce costs and improve patient outcomes, but they also share costs if they fail to meet these goals. In 2017, shared risk models led to a 3.5% reduction in total care costs and improved clinical quality performance (LaPointe, 2019). However, failing to improve care quality or implement cost-effective strategies can lead to financial losses.

Shared Risk Models Influence on Healthcare Management

Managing shared risk models requires careful monitoring to avoid overleveraging. Providers must meet quality standards and demonstrate patient benefits while managing costs. Effective management is crucial for maximizing reimbursement potential and improving quality of care (Brown & Crapo, 2017).

Strategies to Develop Effective Organizational Culture

Building a strong organizational culture is vital for success. Effective communication, leadership by example, focus on results, and employee well-being are key strategies. A culture that aligns with company goals and values drives success and long-term sustainability (Beheshti, 2018; Meehan, Rigby, & Rogers, 2008).

Conclusion

Healthcare organizations must adapt to a dynamic environment to survive and thrive. Emphasizing patient value-based care and addressing barriers are essential for success. Sanford Health Bismarck’s strategic initiatives are designed to improve accessibility, affordability, and profitability in healthcare.

References

Access to Health Services. (n.d.). U.S. Department of Health and Human Services. Retrieved from https://www.health

ypeople.gov/2020/topics-objectives/topic/Access-to-Health-Services

Beheshti, H. M. (2018). Organizational culture and performance: A theoretical framework. International Journal of Business Management and Economic Research, 9(1), 135-145.

Brown, R. T. (2018). Value-based purchasing in healthcare: What you need to know. Journal of Healthcare Management, 63(1), 58-69.

Brown, R. T., & Crapo, L. (2017). Shared risk models in healthcare: A comprehensive review. Healthcare Financial Management, 71(9), 36-45.

Craig, D. (2018). Innovation in healthcare: A new approach to improving patient outcomes. Healthcare Innovation Journal, 12(4), 22-29.

Damberg, C. L., Sorbero, M., & Lovejoy, S. (2014). Assessing the impact of value-based purchasing on healthcare quality: A review of recent evidence. Health Affairs, 33(11), 1884-1893.

HCM FPX 5314 Assessment 1 Aligning Strategic Initiatives to Goals

Gaskell, A. (2017). Building a collaborative culture: Strategies for success. Journal of Organizational Culture, 22(3), 45-56.

Kantor, J. (2019). The costs of emergency room visits vs. urgent care centers. Healthcare Economics, 34(5), 101-110.

LaPointe, J. (2018). The impact of Medicare reimbursement cuts on rural hospitals. Healthcare Management Review, 43(3), 215-225.

LaPointe, J. (2019). Evaluating shared risk models in healthcare. Journal of Health Economics, 42(2), 215-224.

Meehan, M., Rigby, R., & Rogers, B. (2008). Developing a high-performance organizational culture. Harvard Business Review, 86(1), 42-51.

Rothaermel, F. T. (2017). Strategic management. McGraw-Hill Education.

Sanford Medical Center Bismarck. (2019). Annual report. Sanford Health.