HCS/499: Health Care Strategy Capstone

Wk 2 - Summative Assessment: Mission and Vision

As a manager and leader, you must be able to evaluate management and adaptable leadership skills in the health care industry. Important leadership skills are strategic planning and business development. Before you can develop a strategic plan that drives the goals and helps to define what success looks like for you organization, you must have a clear vision and mission. For this assignment, you will demonstrate your skill by evaluating the importance of a mission statement and vision statement for the strategic plan within a health care organization.

1. Assignment Preparation

Review the Stevens District Hospital Strategic-Planning Scenario about a fictional, not-for-profit acute care hospital in Jefferson City. The hospital provides a range of services, including medical/surgical, rehab, and emergency care in a regional market of 80,000 people. This assignment and future course assignments will use the hospital and scenario information.

Imagine the following: Your role in this planning process will be as the director of the radiology department at Stevens District Hospital. Your department performs a wide variety of X-ray procedures, nuclear medicine, ultrasound, and MRI testing. In this planning process, you will evaluate the strengths, weaknesses, opportunities, and threats (SWOT) to the hospital and the role your department can play in increasing business for the hospital.

Review the following mission and vision statements:

• Option 1: Mission: To improve health by providing high-quality care. Vision: Provide the highest level of service in the county.
• Option 2: Mission: To improve health by providing high-quality care. Vision: Provide the broadest range of services in the county.
• Option 3: Mission: To be deeply committed to the communities we serve; we enhance population health and well-being. Vision: Deliver an exceptional experience with every encounter.

Select the most appropriate mission and vision statement for the hospital from the previous list and use the statements for this assignment.

1. Assignment Directions

I have to write a 700 word summary including the following:

• Identify the mission and vision statements you selected for Stevens District Hospital.
• Explain the rationale for why you selected the mission and vision statements.
• Identify the specific strengths of the mission and vision statement selected.
• Identify the weaknesses of the mission and vision statements not selected.
• Explain how the mission and vision statements drive the strategic plan for Stevens District Hospital.

Stevens District Hospital Strategic-Planning Scenario

Background

Stevens District Hospital is a 162-bed acute care hospital that is qualified as a not-for-profit facility. The hospital was originally a county-owned facility, and its status was transferred to an independent facility three years ago. The hospital receives no external funding from government 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 in Jefferson City, which is a city of 50,000 people with 80,000 in the regional market. The hospital provides a general range of acute care services, including medical/surgical, rehab, and emergency care.

Current Performance Analysis

Current Mission and Vision Statements

Our mission: To improve health by providing high-quality care, a comprehensive range of services, and exceptional service.

Our vision: Stevens District 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.

Previous Strategic Plan Review

Goals and Progress Table

Goals	Progress Toward Meeting Goals
Increase market share by recruiting three family practice physicians.	During the past year, the hospital was able to recruit only one family-practice physician to increase primary care market. The limited number of state medical school graduates makes local recruitment difficult.
Improve quality HCAHPS scores in all six criteria to a baseline of the 85th percentile.	The hospital improved HCAHPS scores in four of six criteria. Lagging elements in HCAHPS scores are inpatient patient satisfaction and primary-care patient satisfaction.

Market Forces Affecting the Hospital

Volumes

Volume Changes Last Year Versus This Year

Patients

The continued growth of chronic disease will require changes to the care-management model.

Percent of Population by Age Table

Age Ranges	% Five Years Ago	% Five Years From Now
Under 18	24%	18%
18-44	46%	32%
45-65	26%	30%
Over 65	4%	20%

More than 53% of residents have at least some college education, with just over 29% having an associate's, bachelor's, or graduate degree. More than 90% of residents have at least a high school diploma. The average unemployment rate in the county is 9.9%:

Market Share Distribution Percentage Comparison Table

Hospital	Market-Share Distribution % Five Years Ago	Market-Share Distribution % Last Year
Stevens District Hospital	48%	35%
Competitor Hospital	30%	43%
Out-of-County Hospitals	22%	22%

Figure 1: Patient Origin by Zip Code

Figure 1: In the Patient Origin by Zip Code pie chart, 96101 is Stevens District Hospital zip code and 94963 is major competitor hospital zip code. 52% are from 96101, 20% are from 94963, 16% are from 92106, and 12% are from 93921.

Increases in the percent of population with chronic disease and contributing factors will change significantly over the coming five years.

Chronic Disease Predictions

Payment

There will be continued focus on pay for performance and increased wellness programs. The Affordable Care Act (ACA) is leading to more people being covered; however, there are often high deductibles.

The median household income for county residents is $59,548. On average, households in the 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 next 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.

Percentage of Population by Insurance

Figure 2: Current Payer Mix

Figure 2: The Current Payer Mix pie chart shows that 35% are covered by Medicaid, 30% are covered by Medicare, 24% are covered by commercial insurance, 9% are uninsured, and 2% are noted as "other."

Figure 3: Projected Payer Mix in 5 Years

Figure 3: The Projected Payer Mix in 5 Years pie chart shows that 38% are covered by Medicare, 24% are covered by Medicaid, 32% are covered by commercial insurance, 4% are uninsured, and 2% are noted as "other."

As part of your review of this data, consider the following factors:

• A portion of the population will become Medicare eligible.
• The addition of manufacturing positions that include benefits will increase commercial insurance coverage.
• Changes from the ACA will increase the number of patients in the market with insurance coverage.

Employers

There is expected growth in large employers with the addition of the automotive factory in the northwest sector of the county.

Physicians

The continued shortage of medical staff, especially in orthopedics, oncology, and primary care, will require increased recruitment efforts.

Competitors

Hanover County Hospital, which is the other hospital in the county, has an updated facility that has drawn more market share to its facility.

Competitor Analysis Table

Competitor Name	Competitor Type	Key Areas of Competition	New Programs and Facilities	Risk to Market Share
Hanover County Hospital	Primary competitor	Facility upgrade Quality scores	Significant renovation of core hospital to update aesthetics Added new wide-bore MRI machine last year Reached the 95th percentile in five of six HCAHPS categories	Drawing patients to newer facility Accommodating patients with a wider range of body weights Patient perception of higher quality and patient satisfaction
Medical Center Located in County South of Stevens District Hospital	Primary competitor	Physician clinics Financial stability	E-visits with specialists Low debt and high cash on hand	Drawing patients out of primary and specialty care at Stevens District Hospital Ability to cash-flow projects
Retail Pharmacy Instant Clinic	Secondary competitor	Low acuity office visits	Pharmacy added instant clinic in north part of county 6 months ago	Loss of patients from primary care physicians' practices

Technology

A competing hospital has added e-visits for physician practices, which is causing a shift of patients to the competitor hospital's physician practices.

Regulatory Changes

Health care reform through the ACA has increased the number of patients with some form of insurance payment. These patients are now seeking care from a primary care physician in greater numbers. Stevens District Hospital struggles with accommodating patient scheduling requests to establish care with a primary care physician.

Planning Components Explanation

Planning Components Explanation Table

Components	Definition	Examples	Measurement
Goal	Organization goals that cover broad strategic issues, such as quality, finances, and growth	Improve HCAHPS scores by 5%. Improve operating margin by 3%. Increase market share in 96103 zip code by 5%.	Percentage increase in operating margin Percentage change in market share
Objective	Broad action items that address organizational goals, such as increased market share, increased use of technology, and increased physician satisfaction	Improve emergency department patient satisfaction survey by 5%. Grow urgent care visits by 10%.	Percentage change in the emergency department (ED) satisfaction survey Percentage change in urgent care visits
Actions	Action item that meets an objective, such as implementing EMR, renovating physician lounge, and increasing marketing for specific products	Implement urgent care center in north zip code. Purchase tablets for physicians for EMR rounding.	Number of patient visits at new urgent care center Percentage increase of EMR use

Financial Summary

Financial Summary Table

Revenues and Expenses	This Year (In $)	Last Year (In $)
Operating Revenues	n/a	n/a
Net revenues from services to patients	343,737,280	344,726,245
Other operating revenues	16,846,309	20,311,534
Total operating revenues	360,583,589	365,037,779
Operating Expenses	n/a	n/a
Salaries and benefits	192,053,379	182,853,245
Supplies and other expenses	130,173,477	135,560,131
Depreciation	18,969,799	20,644,157
Interest	2,695,623	2,226,437
Foundation	628,184	1,182,308
Total operating expenses	344,520,462	342,466,278
Income From Operations	16,063,127	22,571,501