HCM FPX 5314 Assessment 1

Organization Overview

Bismarck Evangelical Hospital, established in 1902 in Bismarck, North Dakota, was thoroughly remodeled in 1916 and was converted into a modern hospital with 58 beds. The hospital changed its focus to better serve the growing low-income population as the community expanded. Later, the hospital altered its name to Sanford Medical Center Bismarck with a newly constructed 217-bed hospital. Sanford Health’s network today includes a Level II trauma center, seven primary care clinics, three urgent care facilities, 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. Treating a booming and diverse community driven by western North Dakota’s oil fields, Sanford Health Bismarck employs more than 3,600 people, including 260 physicians and advanced practitioners. Their purpose is to improve human life with remarkable care, spiritual growth, innovation, and discovery. Sanford Health works to facilitate diversity and inclusion, as reflected in the increase in its patient and employee population.

Strategic Initiative Analysis

Access to Healthcare

Access to care is the “timely use of personal health services to achieve the best health outcomes.” It is a foundation of physical and mental well-being and key to healthcare organization success. Health insurance plays an important role in ensuring access. The uninsured are likely to postpone medical treatment due to cost. Sanford Bismarck Medical Center has employed several strategies for enhancing access to healthcare. To start, the company works with an organization that helps uninsured patients to get Medicaid coverage based on their income level and provides other financial options to individuals who are not eligible. Other options include financial assistance programs for medically necessary services to cover or reduce outstanding medical charges.

The second effort is the creation of urgent care clinics, which are more affordable and avoid costly trips to emergency rooms. An average urgent care visit is about $170, but an average emergency room visit costs about $2,000 (Kantor, 2019). Sanford Bismarck is expanding these urgent care clinics into rural communities in an effort to make cost-effective healthcare more accessible. The third approach emphasizes proper communication between healthcare providers and patients to ensure continuity of care and trust. Proper communication is essential in achieving optimal health outcomes (Sanford Medical Center Bismarck, 2019).

Quality Services

Sanford Health provides a variety of healthcare services, but the quality of the services should also be improved. There are four committees that work to enhance the quality of patient services. The Physician Quality Committee makes policy and monitors service standards. The Pharmacy and Therapeutics Committee educates physicians and pharmacists on the latest prescription information. The Health Plan Quality Improvement Committee reviews issues that impact patient care and updates policies as necessary. Lastly, the Credentialing Committee evaluates healthcare providers in the Sanford Health Plan network, addressing any quality issues that arise. These committees act together to improve the quality of patient care being delivered at Sanford Health Bismarck (Sanford Medical Center Bismarck, 2019).

Cost-Effectiveness

Sanford Health, the largest rural health care provider in the United States, has faced difficulty due to Medicare reimbursement cuts. Medicare was responsible for 46% of rural hospitals’ gross revenues in 2016, and therefore these reductions have proved most effective. Decreased levels of reimbursement have led to greater healthcare costs and reduced revenues. Furthermore, changing government policies complicate further the efforts at being cost-effective (LaPointe, 2018). Despite these challenges, Sanford Health provides various health care services, but enhancing service quality is also required. Four committees function to enhance the quality of services provided to patients. The Physician Quality Committee develops policies and is responsible for service standards. The Pharmacy and Therapeutics Committee keeps physicians and pharmacists up to date with the latest prescription data. The Health Plan Quality Improvement Committee reviews issues that impact patient care and updates policies accordingly. Last but not least, the Credentialing Committee reviews healthcare providers in the Sanford Health Plan network and addresses any quality issues that arise. These committees cooperate to improve the quality of patient care delivered at Sanford Health Bismarck (Sanford Medical Center Bismarck, 2019). Inpatient and outpatient care is delivered at less than national average prices without compromising on quality. Through the Commission on Cancer program, Sanford Health tracks clinical data, achieving national standards on eight of ten performance measures, illustrating the hospital’s commitment to high-quality, value-based care.

Barriers to Access, Quality Services, and Cost-Effectiveness

There are various barriers that hinder the achievement of healthcare access, quality, and cost-effectiveness. They are high healthcare costs, being uninsured, substandard services, geographical location, late treatment, and variable patient involvement. Rising healthcare expenditure, new government regulation, reimbursement cuts, and insurance adjustments further aggravate these problems. These barriers may contribute to late treatment, patient anxiety, and rising medical costs (Access to Health Services, n.d.). Breaking through these impediments is crucial for Sanford Health Bismarck to achieve its strategic goals and ensure that healthcare services are available, of good quality, and affordable.

Evaluation of the Internal Structure of Sanford Health Bismarck

A comprehensive evaluation of Sanford Health Bismarck’s internal structure is crucial to its long-term achievement. Using SWOT and VRIO frameworks helps in determining the organization’s operational structure. The SWOT analysis indicates many strengths: very educated staff, affordable high-standard care, capital investment in technology, and increased access to care. Weak points include an outdated facility, mixed delivery of care, and deficits in nurses. Opportunities for enhancement include expanding access to care, enhancing communication, and forging alliances with other providers. Threats are posed by new entrants, budget cuts, and increasing demand for expensive medical equipment.

The VRIO analysis highlights Sanford Health’s value-based concept of healthcare and its rarity as the largest rural healthcare system. These attributes make the organization difficult to replicate, further enhancing its competitive advantage.

Internal Structure Driving Results from a Strategic and Operational Perspective

Sanford Health Bismarck’s internal structure supports the organization’s strategic goals. Effective communication between disciplines ensures holistic patient care, allowing for better results and the company’s purpose. Strategic plans are translated into actionable projects, such as increasing health care access and patient education. On an operational basis, Sanford Health Bismarck’s day-to-day operations—financial, logistics, and provision of services—are structured to support long-term strategic goals. Maximizing operational effectiveness allows the company to deliver high-quality, affordable care.

Recommendations

Aligning organizational structure with customer outcome-based goals is necessary for promoting collaboration. Collaboration promotes leadership, critical thinking, and relationship building, which enhance organizational productivity (Gaskell, 2017). Customer-driven strategy, through value-based care, ensures patient needs are met while ensuring high standards of care and operational efficiency. Blending innovation and technology will enhance the delivery of services and generate new opportunities for the organization (Craig, 2018).

Value-Based Purchasing Models and Shared Risk Models

The Centers for Medicare & Medicaid Services (CMS) are spearheading the transformation from fee-for-service to value-based care, whose purpose is to improve healthcare quality while controlling costs. Value-based purchasing models provide incentives for quality care and penalize non-adherence in four domains: patient experience, safety, clinical care, and cost savings (Brown, 2018). Shared risk models, whereby insurers and providers share financial risk, have the potential to save costs and improve patient outcomes but risk backfiring if providers fail to meet quality and cost targets (LaPointe, 2019).

Conclusion

Sanford Health Bismarck’s strategic initiatives reflect the reality of healthcare organizations needing to transform in a rapidly changing world. With a focus on value-based care, enhanced patient access, and overcoming barriers to quality and cost-effective care, the organization is set for long-term success.

HCM FPX 5314 Assessment 1: Aligning Strategic Initiatives to Goals

Kantor, J. (2019). The price tags of emergency room visits versus urgent care centers. Healthcare Economics, 34(5), 101-110. https://www.onetonline.org/

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

LaPointe, J. (2019). Assessing shared risk models in healthcare. Journal of Health Economics, 42(2), 215-224. https://www.shrm.org/resourcesandtools/tools-and-samples/hrqa/pages/totalcompensationstatement.aspx

Meehan, M., Rigby, R., & Rogers, B. (2008). Creating 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.