HCS 449 University of Phoenix Business Plan Presentation

HCS 449 Capstone Business Plan Scenario Background Community Hospital is a 180-bed acute care hospital that is qualified as a not-for-profit facility. The hospital was originally a county-owned facility and transferred status to an independent facility three years ago. The hospital receives no external funding from governmental agencies for operations. The hospital is accredited by The Joint Commission and received reaccreditation during their triannual survey last year. The hospital has an aggressive quality management program and a low volume of medical malpractice claims. The hospital is located in Bedford, which is a city of 50,000 people with 80,000 people in the regional market. The hospital provides a general range of acute care services including medical and surgical, rehab and emergency care. The president of the hospital has asked you to evaluate the feasibility of establishing an off-site urgent care center at a local mall. You will use data provided in this scenario to make your decisions and recommendations. Current Performance Analysis Mission and Vision Our Mission- To improve health by providing high-quality care through a comprehensive range of services. Our Vision- Community Hospital and its affiliates will be the health care provider of choice for physicians and patients. Our five-year vision is to create a large, multispecialty physician practice system that would include at least six family practice physicians and specialists in cardiology, oncology, and women’s services. Currently the hospital employs three family practice physicians, one obstetrician, one medical oncologist, and one non-invasive cardiologist. Market Forces Affecting Hospital Copyright © 2017 by University of Phoenix. All rights reserved. 1 Volumes Volume changes last year versus this year 30000 26292 25000 20930 20000 15000 10000 5000 4458 6365 5147 405 7284 472 0 Admission ER visits Deliveries Last year Surgeries This year Patients The continued growth of chronic disease will require changes to the care management model. Percent of population by age: Under 18 18 to 44 45 to 65 Over 65 Five years ago 24 46 26 4 Five years from now 18 32 30 20 Copyright © 2017 by University of Phoenix. All rights reserved. 2 Over 53% of residents have at least some college education, with just over 29% possessing an associates, bachelors, or graduate degree. Over 90% of residents possess at least a high school diploma. The average unemployment rate in the county is currently 9.9%: Market share distribution percentage with major competitor: Community Hospital Competitor Out of County Hospitals Five Years Ago 48 30 22 Last Year 35 43 22 Patient Origin by Zip Code 92106, 16% 93921, 12% 94963, 20% 96101 is Community Hospital zip code 94963 is major competitor hospital zip code 96101, 52% Payment Continued focus on pay-for-performance and increased wellness programs. Affordable Care Act creating more covered lives, however often with high deductibles. Copyright © 2017 by University of Phoenix. All rights reserved. 3 The median household income for county residents is $59,548. On average, households in county earn more than the state median household income of $44,446 and more than the national average of $53,650. The addition of a new automotive manufacturing plant to the local market this coming year is projected to add 1,500 production line jobs and 300 administrative jobs by year end. Median income for the production positions is estimated at $45,000 and will provide health, vision, and dental insurance benefits. Current Payer Mix Uninsured, 9% Projected Payer Mix 5-years Uninsured Other 2% 4% Other, 2% Medicaid, 35% Commerci al, 24% Medicare, 30% Medicare 38% Commercial 32% Medicaid 24% Percentage of Population by Insurance As part of your review of this data, consider that a portion of the population will become Medicare eligible, the addition of manufacturing positions that include benefits will increase commercial insurance coverage and changes from the Affordable Care Act will increase the number of patients in the market with insurance coverage. Employers Expected growth in large employers with addition of automotive factory in northwest sector of county. Copyright © 2017 by University of Phoenix. All rights reserved. 4 Physicians Continued shortage of medical staff, especially in orthopedics, oncology, and primary care will require increased recruitment efforts. Competitors Other hospital in county, Hanover County Hospital, has an updated facility, which has drawn more market share to their facility. Competitor Key Areas of Competition New Programs and Facilities Risk to Market Share Primary Competitors Hanover County Hospital Facility upgrade Significant renovation of core hospital to update aesthetics Drawing patients to newer facility Added new wide-bore MRI machine last year Reaching 95% percentile in five of six HCAPS categories Patient perception of higher quality and patient satisfaction Quality Scores Medical Center in county south of Stevens Accommodates heavier patients Physician clinics E-visits with specialists Financial stability Low debt and high cash on hand Drawing patients out of primary and specialty care at Stevens Ability to cash flow projects Secondary Competitors Copyright © 2017 by University of Phoenix. All rights reserved. 5 Retail pharmacy instant clinic Low acuity office visits Pharmacy added instant clinic in north end of county 6 months ago Loss of patients from primary care physicians practices Technology Addition of e-visits by large hospital system in adjoining county has drawn more market share to their physician practices. Regulatory Changes Health care reform through the Affordable Care Act has increased the number of patients with some form of insurance payment. These patients are now seeking care in greater numbers from a primary care physician. Community Hospital currently struggles with accommodating patient scheduling requests to establish care with a primary care physician. Financial summary This year Last year 343,737,280 344,726,245 16,846,309 20,311,534 360,583,589 365,037,779 Salaries and benefits 192,053,379 182,853,245 Supplies and other expenses 130,173,477 135,560,131 18,969,799 20,644,157 2,695,623 2,226,437 Operating Revenues Net revenues from services to patients Other operating revenues Total operating revenues Operating Expenses Depreciation Interest Copyright © 2017 by University of Phoenix. All rights reserved. 6 Foundation Total operating expenses Income from Operations 628,184 1,182,308 344,520,462 342,466,278 16,063,127 22,571,501 Urgent Care Location Options Location One is located at a strip mall on the north side of town with a twenty-minute drive to the main Community Hospital campus. The potential lease space is a vacant storefront that previously housed a video store. The building is mostly an empty shell that would require $30,000 in renovation to create acceptable medical office space with four exam rooms. Lease cost of location is $3,000 per month for a total of 1,800 square feet. Utilities are not included in the lease rate. Location Two is located at a strip mall location on the south side of town with a thirty-minute drive to the main Community Hospital campus. The lease space is a vacant grocery store. The building is mostly an empty shell that would require $35,000 in renovation to create acceptable medical office space with four exam rooms. However, the total space is very large, at 5,000 square feet, so there are other options available that could also be housed in that space. Lease cost of location is $6,500 per month for a total of 5,000 square feet. Utilities are not included in the lease rate. The owner is not willing to subdivide the space for lease by multiple parties. Copyright © 2017 by University of Phoenix. All rights reserved. 7 Running Head: BUSINESS RECOMMENDATION Business Recommendations Tara Dunlap HCS/449 02/10/2020 1 BUSINESS RECOMMENDATION 2 Business Recommendations The recommended service that Community Hospital should provide at the new center is women services. They should include maternity care, high-risk maternity care, breast health, gynecology, fibroid and menstrual disorders, among other services. These services are recommended because they are in line with the vision of Community Hospital in the next five years. The facility aims to create a large multispecialty physician system that includes women services among other areas of specialization. Establishing the center as for women services will be a milestone to the achievement of the five years vision while increasing the health service to the growing of patients that are covered by the Affordable Care Act. This area of specialization will also be instrumental to the Community Hospital in gaining competitive advantage in the market. Most of the competitors of this facility have different areas of focus. For example, the Medical Center in South of Stevens focuses on physicians’ clinics and financial stability as its competitive advantage while Hanover County Hospital has facility upgrade ad quality scores as its competitive advantage. The Community Hospital should base its competitive advantage on multiple specialties, and the first step would be establishing women services at urgent care. The most appropriate site would be at the strip mall located on the south side. Although it has a relatively high cost of renovation, this site is preferred and economical in the long term. It has a large space for future expansion of the hospital, especially because the owner is not willing to let it to multiple people. Hours of Operations The recommended hours of operation should be between 0800-1700 hours. This time should be set for consultations. Patients that may need specialized care should be admitted within BUSINESS RECOMMENDATION 3 the facility to be monitored by nurses. This time is recommended because the county is experiencing a shortage of medical practitioners. Besides, the time will ensure that a large population in the community is served without straining the working hour of the medical staffs. The facility will also need to develop a flexible schedule for the staff to accommodate their personal needs as well as addressing the needs of the patients. Such an approach will improve their productivity and efficiency in delivering quality care and also increase their retention in the facility. Major Equipment for the Services One of the equipment that the hospital will need is a mammography system. It is specialized equipment that examines the breast by utilizing a low dosage of x-ray. It helps in detecting breast disorders in women. It is preferred since it allows physicians to identify and treat various medical conditions using noninvasive medical tests. The purchase of this system will be a significant capital investment for the Community Hospital. The facility has three options for the system that can be considered according to their related costs. The 2D models are the cheapest and range between $65,000 and $9500 (Block, 2020). Examples include the Hologic Selenia and GE Senographe Essential, all with a similar price range. Most of these models have stereotactic capabilities and gantry rotation control. However, they are less effective than the 3 D Models that capture images in three dimensions. Examples include Hologic Dimension and 3D Tomo with Senoclaire. The price range of most of these models is between $90,000 and 200,000. The Premium 3D Models are the most expensive and the latest versions of the mammography system whose cost run between $140,000 and &275,000 (Block, 2020). This system produces better pictures using the lowest radiation dose. The cost of the system includes a free one year service and installation. BUSINESS RECOMMENDATION 4 A Gynecological Exam Table will be required to offer physicians the ease of examining the reproductive system of women for appropriate diagnosis and treatment. The Versatile Examination Couch Iduolys Model costs an average of $4,769 (Block, 2020). It is electrical and can accommodate up to 250 kilograms. The Elansa Gynacological Couch has a footrest and stirrup and can accommodate patients weighing up to 170 kilograms. Its average cost is $5695.76 (Block, 2020). This equipment facilitates the assessment of many disorders of the reproductive system through examination. Among the technologies that the new center can utilize is 3D Printing to create multidimensional models of the body parts of patients. The technology can be used to help patients understand their medical conditions because it can be customized to produce tools that accurately follow the unique anatomy of patients (Burrill, 2018). Wearable Monitoring Patches can be utilized to track and monitor the patients in terms of their blood pressure, pulse rate, and such related vital signs. This approach can be utilized to offer frequent check instead of scheduled examinations alone, leading to improved patient care. Sensors that monitor the levels of anxiety and stress in patients can also be utilized in the facility since these measures correspond to the blood pressure and pulse of patients. This technology will be significant in supporting the vision of Community Hospital to expand in the midst of the shortage in medical staff. Type of Corporation The new center should be established as a department of the hospital. This type of ownership will limit the liability of the main hospital. In this approach, the potential center can be used to protect the parent hospital from losses and other related liabilities. It implies BUSINESS RECOMMENDATION 5 protecting the Community Hospital from possible lawsuits that can interfere with its mission of healthcare delivery. The ownership is recommended because as a department, the new center has limited transaction and regulatory requirements that can attract stakeholders such as donors to join in the mission of offering healthcare services and expanding (LaMarco, 2019). The main hospital will be able to offer the department with all the needed support such as medical staff, supplies, and equipment to start its operations and steer ahead of the vision of the Community Hospital. By operating as a department, the new center will give this hospital the opportunities for diversifying its service delivery without compromising its primary identity since it will offer more specialized services than the parent hospital. Besides, the hospital will be able to test different aspects such as leadership, marketing options, and even payment methods at this department at a small scale without disrupting the service delivery at the Community Hospital. The successful projects may be integrated smoothly in the main hospital to improve its efficiency and competitiveness. BUSINESS RECOMMENDATION 6 References Block.J. (2020). Digital mammography equipment price/cost info. Retrieved from https://info.blockimaging.com/bid/95356/digital-mammography-equipment-price-costinfo Burrill, S. (2018). Health care outlook for 2019: Five trends that could impact health plans, hospitals and patients. Retrieved from https://www.modernhealthcare.com/article/20181207/SPONSORED/181209938/healthcare-outlook-for-2019-five-trends-that-could-impact-health-plans-hospitals-and-patients LaMarco, N. (2019). The advantages & disadvantages of creating subsidiary & operating companies. Retrieved from https://smallbusiness.chron.com/advantages-disadvantagescreating-subsidiary-operating-companies-25733.html

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