ABC Company: Premier Managed Care Health Insurance Provider

The healthcare industry consists of many strengths and weaknesses during the improvement of patient safety, efficient operations, reduction of medical errors, and ensuring that they provide timely access to all patient information. This will have to still comply with all legal guidelines as they control costs and protect patient privacy. The adoption of advanced information technology is a popular strategy being used in the healthcare industry because it allows their weaknesses to be progressively diminished as they gain and use the opportunities necessary as an analytical tool. This would allow their capabilities to be further developed with the new technologies and processes used as they unify the adoption of IT standards. In order to stay competitive within the healthcare industry, then there must be specific actions and measures that must be taken to ensure a positive outcome. This includes external opportunities to increase the capability of the IT infrastructure in a national environment as the growth of industry standards are met in order to decrease the pressured threats of legal compliance through patient trust and the high cost of IT. The growing recognition of strategic leadership often leads to both improved financial stability and contact accessibility of the system. Some challenges that may occur within the healthcare system may cause issues in a hospital setting because of the centralized society of an organization. This is because of the different visions and

This week I began my 6-week internship at Blue Cross Blue Shield of Nebraska (BCBSNE). The first day was a common orientation for all new employees, internally denoted to as the “onboarding process” where all employees are told they matter. This full-day session communicates the core mission, vision and goals of BCBSNE, organizational structure, operating objectives, and workplace culture. BCBSNE is a not-for-profit health insurance company that is focused on collaboration to find the best solution for their customers; in other words, they are customer-focused. Since the implementation of the Affordable Care Act (ACA), many changes to the health insurance market required a change in the organizational structure and culture of BCBSNE. Through partnerships with providers, the goals of BCBSNE are to be responsive, accountable, minimize errors, and decrease costs – all components of the ACA. BCBSNE has strategically aligned their goals to those of the government-mandated goals, and implemented them at all levels of the organization, making them competitive in the health insurance market. I found this very fascinating: I was very excited after day one!

HealthSouth Corporation was incorporated in January 1984 in Birmingham, Alabma by the founder Richard M. Scrushy. HealthSouth Corporation is the leading provider of medical rehabilitation health care and outpatient surgery services in the United States. Richard M. Scrushy was the former CEO& Founder of HealthSouth Corporation, and there were 5 CFO which were Aaron Beam, Weston, Smith, Bill Owens, Michael Martin and Tadd Mcvay.

A powerful force for change can be created by embracing transparency. According to the Department of Health and Human Services, “transparency is a broad-scale initiative enabling consumers to compare quality and the price of health care services so they can make their own informative choices among doctors and hospitals. This initiative is laying the foundation for pooling and analyzing information about procedures, hospitals and physicians services. In order to create value driven health care, there are four steps to turn raw data into

To guarantee that its members receive appropriate, high level quality care in a cost-effective manner, each managed care organization (MCO) tailors its networks according to the characteristics of the providers, consumers, and competitors in a specific market. Other considerations for creating the network are the managed care organization's own goals for quality, accessibility, cost savings, and member satisfaction. Strategic planning for networks is a continuing process. In addition to an initial evaluation of its markets and goals, the managed care organization must periodically reevaluate its target markets and objectives. After reviewing the markets, then the organization must

There are many challenges that are defining the future strategic direction of health care such as information technology advancements, access to health care, maintaining a skilled workforce, proposed health care reform and legislation, and rising costs. I will look at these challenges and how an organization may adapt its direction and strategies in accordance with these challenges.

The thought process behind consumer-driven health plans is that consumer activities can be improved in ways that will lessen the cost and

Since the mid 1990’s, a predominant concept of healthcare is the iron triangle of care, consisting of three competing issues: quality, access, and cost. (Carroll, 2012). William Kissick, who introduced the model, suggested that if you improve one or two of these issues areas, it comes at the expense of the third. If quality of care is increased, it comes at the expense of access or through increased cost. If access to care is improved, it is at the expense of quality or increased cost. If an institution is successful at cost containment while providing care, it is at the expense of quality and/ or access. (Kissick., 1994, p.13). Despite this deeply ingrained concept, the Agency for Healthcare Research and Quality (AHRQ) viewed the use of Health Information Technology (HIT) in the nation’s healthcare delivery as a resource to promote quality and access while potentially decreasing overall cost. (U.S. Department of Health & Human Services, 2003). (Page 175 of Delivering Healthcare in America) In efforts to promote the use of HIT, AHRQ provided five goals of implementation that would best impact the healthcare provided throughout the federal and private healthcare systems. These goals, when applied to the federal

In the healthcare field, there are forces that drive practice and develop change within an organization. There are both internal and external forces in which not one organization is immune to (Kotter, 1996). By establishing a vision of the company, a sense of purpose and direction is created, working towards change within the forces (Huyer, 2014). When people participate in a vision, they work towards a common goal and identify what needs to be changed in order to reach that vision. In this paper, a presentation of Banner Health will be discussed, along with its mission and stakeholders, driving forces, viability, as well as an analysis of forces, a response to change, a vision for change, and an evaluation of change.

Advances in modern technology surrounds us in our day to day lives, allowing conveniences and efficiency at our fingertips. Great strides have been made over the years with technology, and the healthcare industry along with many other industries have adopted this new way of functioning; electronically. The effects of technology have come to the forefront in where our government has acknowledged the benefits and opportunities. “The promise of Health Information Technology for improving quality and safety of health care while reducing costs has caught the eye of policy makers and other leaders in health care” (Hersh, 2006). It deeply affects how we connect, interact, and communicate internally and externally, but also gives us a sense of control on how we engage ourselves to the innovative software and systems.

First, the company’s infrastructure could not allow members to connect varied sources of data and metrics that would enable them to see a possible way to apply the healthcare reforms. Also, the applications did not have a way to scale down or measure the increased number of transactions that were needed in the new changes to the health reforms. Additionally, the company wanted to retain the

The health care industry is one of the most dynamic and delicate industries in the U.S. having experienced healthy and substantial changes for the last thirty years most of which have aimed to improve health care management and services delivery to the patients. The changes have enabled the integration of technology into the industry such as in the area of informatics, science and research and payment services and clinical treatments. The health care sector has introduced various changes to address disease and health care management such as the Modernization Act of 2003, the Patient Protection Act and Affordable Act, which aim at improving health provision and most

The benefit of technology in healthcare can help improve quality of care and reduce adverse events. Kaiser Permanente invested in an electronic medical system to increase positive clinical outcomes. Implementation of the health information system would have three system functions. The first objective was to reduce operating cost by improving staff efficiency, reduce patient’s number of hospital days, and reduce adverse drug events and increase preferred prescription adherence. The second objective was to increase revenue which was accomplished by improving appropriate billed charges, improving coding accuracy for Medicare risk, and increase collections. Decreasing capital expenditures was the final function which was achieved by decreasing

The variation in information needs across any healthcare provider organization forces healthcare information technologies (HIT) platforms, systems, processes and procedures to align its design to support the unique information needs of each department and role. The greater this alignment of HIT systems and technologies to specific administrator, doctor, nurse and lab technician roles, the higher the level of overall systems performance and results attained (Agrawal, Grandison, Johnson, Kiernan, 2007). Just as an enterprise has strategic information needs that help to define the future direction of the business, healthcare provider organizations also have a comparable set of strategic information needs. The administrative roles in healthcare providers need to have a consolidated view of the organization from a cost, quality management, service level, patient recovery rate, patient satisfaction and profitability standpoint as well (Middleton, 2005). All of these factors are often gathered together in a dashboard that administrators often rely on to manage the core areas of their healthcare business (Leung, 2012). Administrator's information needs are also longer term in nature and more oriented towards the development of strategic initiatives that will last several years, requiring

The successful implementation and subsequent meaningful use of information technology solutions within a health care organization is a challenging and iterative process. The organization must engage in careful and ongoing strategic and tactical planning to ensure that the implemented technology will ultimately be effective and beneficial for its practitioners, staff, and patients.