Capital Cycle : A Competitive Market

The Institute of Medicine’s (IOM) six aims of quality provide an advantageous framework to progress the quality of care in the U.S.A. health care system. IOM developed six aims for improving to provide safe, effective, patient-centered, timely, efficient, and equitable patient care (Institute of Medicine, 2001). Organizations need to strategically plan to evolve in meeting IOM’s six aims and to remain a financially sound entity. Strategic planning involves defining the future and stipulating the measurement of achievement (Sare & Ogilvie, 2010). The purpose of this paper is to start the initial steps for creating a strategic plan in a healthcare organization, through describing and evaluating an unmet need, considering the mission, vision, and values, providing the background context, vision, strategic goal, and consider the broader issues.

There are different types of budgeting that businesses typically use and those include Operating budgets, Capital Budgets and there are many subtypes that exist because a budget can also be created for special events, the recruitment and retention of new staff, and to manage the advertising expenses and return on investments for a business (Demand Media, 1999-2012). According to Demand Media (1999-2012), "An operating budget outlines the total operating expenses and income for the organization, typically for the period of a fiscal year. Capital budgets evaluate the investments and assets of the business, and a cash budget shows the predicted cash flow in and out of the business over a period of time” (para.2 ). According to the Cost-Benefit Analysis (2012), “Capital budgeting has at its core the tool of cost-benefit analysis; it merely extends the basic form into a multi-period analysis, with consideration of the time value of money. In this context, a new product, venture, or investment is evaluated on a start-to-finish basis, with care taken to capture all the impacts on the company, both cost and benefits. When these inputs and outputs are quantified by year, they can then be discounted to present value to determine the net present value of the opportunity at the time of the decision” ("Cost-Benefit Analysis," 2012).

My strategy will consist of three phases. These phases include: capital shortage, funding options for equipment acquisition and funding options for capital expansion. During these three phases I will observe the necessary financial statements and documents. From this information I will analyze the information and decide the best strategy for improvements. I will not only focus on the goals for the clinic, but long term budget goals as well.

The finance department has reported that Elijah Health Center is facing a potential working capital shortfall which means the hospital may not have enough cash to sustain itself. The reasons for this shortfall is due to huge discounts given to managed care companies, higher wages given to contract nurses, low Medicare reimbursement levels, growth in current liabilities, and unused equipment. I will provide the best strategy in order to sustain the cash flow problem that Elijah Heart Center is facing. My strategy will consist of three phases. These phases include: capital shortage, funding options for equipment acquisition and funding options for

Capital planning and budgeting is a very vital piece in the Public Budgeting System process. It is an essential implement in the financial management practice and is effective in both public and private organizations. It is the method which consists of the determination and the evaluation of the investments and the possible expenses by an organization. As explicate by Lee, Johnson, & Joyce (2008), capital budgets help in determining how much of each form of investment is needed, and it supports an organization in assessing the available revenue which includes loans is required to finance those investments (p. 475). Capital budgeting is a central part of the universal

The society we reside in has evolved to the point of no return. Most of our health care system consist of technology, implementation, goals, scanning, monitoring, forecasting and assessing. However, critical strategies and resource priorities involve ensuring that all the essential elements are currently met within the organization. Also, prioritizing strategies are as follows strategic thinking, strategic planning and managing strategic momentum. Each facet acknowledges and identifies what is important in hospitals and health care. Therefore, the delivery of each process allows the organization to recognize the need for the patient and population. THE LITTLE BOOK “the plan sets direction for the organization and through a common understanding

Without strategic planning, several things can go wrong including missing out on great opportunities. Strategic planning is an organization’s outline to help achieve its purpose. Although strategic planning begins at the top of the pyramid, it is more effective when it is carry out as a whole among other in the organization. Having a good internal control system in place protects an organization from high risk, fraud, and more. Jackson Memorial Hospital has several weaknesses which are similar to its competitors and other health care organizations. For instance, Mount Sinai Medical Center one of Jackson Memorial’s competitors, encountered lack of strategic planning that led to many issues such as with readmissions, surgical complications,

Over the past years, “the healthcare sector of our economy has grown rapidly”, (Cleverley, Cleverley, & Song, 2011, p. 10). In order for healthcare organizations (HCOs) to survive in our financially changing healthcare environment, they must be economically stable. The understanding of the effects of economic developments on finance is more important than ever. By understanding the financial and economic implications of our economic system, healthcare organizations will be capable of securing economic stability. When trying to stabilize financial security in healthcare capital planning is the best approach. If the working capital is not managed efficiently, the flow of money gets choked, raw material supplies interrupted, wage payments delayed,

“Representing over 20 percent of the U.S. Gross Domestic Product and accounting for approximately $1.5 trillion in revenue, health care is the single largest industry in the U.S. today.” (University of Phoenix, 2015). However, it is a vulnerable industry. The facility we are looking at is in New York, where the third highest losses in the country occur because of numerous problems dealing with Medicare and Medicaid reimbursements, cuts in funding, and pressures for discounted managed care, amongst others. The facility is called Elijah Heart Center (EHC). First we looked at the capital shortage because in an emergency, the hospital might not have enough cash to sustain itself. The challenge was to decide on the best strategy to solve the

I agree with you hospitals and other healthcare facilities are like any other organization and need to management team who have strong strategic planning skills. Dynamic nature of healthcare system where new innovations are highly desirable, encourage dynamic strategic thinking and healthcare managers need to assemble strategies which can be adjusted as per changing market landscape. In doing so the healthcare managers initiate strategic planning process which focus on relevant and lasting transformations for the future and integrates the organization’s short, medium and long term objectives. As you mentioned, that a heath care facility may fail because of its failure to think strategically while and adapt to latest technologies.

As healthcare organizations adapt to the changes due to Healthcare Reform, many organizations are faced challenges with decreasing revenues in relation to the transforming from volume to value-based purchasing that have deteriorated reimbursement payment rates and preventive care that keeps patients healthier while reducing inpatient revenues along with escalating cost to do business due to more compliance cost, and the encouraging of integration through the accountable care organization model. (Brown, Werling, Walker, Burgdorfer & Shields, March 2012). As a result of Healthcare Reform, many organizations have been driven by environmental forces and ongoing trends to consolidate with other healthcare systems to deter the effect of these changes due to the new healthcare laws through the desire of gaining more capital, opportunities for future investments, and to better compete in the healthcare market (Healthcare Financial Management Association, Dec 2016.).

For several decades health care has been tied to the economy and with the current downturn we see continued efforts to control and reduce over-head costs. Health care organizations in their effort to become more efficient and address changes in the industry have altered their strategic business plans. Lee & Alexander (1999) researched organizational change in hospitals and their survival, in this paper I hope to discuss their findings and add other examples to validate their conclusions.

Though they are not entirely comprehensive tools, a great deal can be learned about a hospital or other healthcare organization for-profit or not-for-profit from an examination of their annual financial documents (Finkler & Ward, 2006). The balance sheet and statement of revenue and expense can both yield valuable clues even in the absence of other evidence about changes that might be occurring in the organization, a definition of the type and degree of certain problems that it might be facing, and potential opportunities for improvement in performance that might exist (Finkler & Ward, 2006). Comparing two or more years' worth of financial information yields even more valuable insights, tracking movement in the hospital or other organization's ability to finance its activities and thus continue providing services at the same level, quantity, and scope as current operation.

These health care organizations have two types of planning to follow, and they are tactical and strategic planning. When tactical planning takes place, there is a short term goal in mind (Society for Human Resource Management, 2102). The course of action for a tactical plan is to achieve a goal within a year or less time period (Society for Human Resource Management, 2102). A tactical plan has a smaller scope and shorter time span than a strategic plan (Society for Human Resource Management, 2102). It takes several tactical plans to achieve the strategic plan (Society for Human Resource Management, 2102). Strategic planning differs from tactical planning, because in strategic plan, the course of action is to achieve goals for the long term (Society for Human Resource Management, 2102). Strategic planning goals are usually wanted to be completed with five years (Society for Human Resource Management, 2102). The organization’s mission statement purpose and direction are reflected upon strategic planning (Society for Human Resource Management, 2102). Top management must view reports on operations, external environments and finances when looking to develop a strategic plan (Society for Human Resource Management, 2102). The development of tactical plans are influenced by strategic plans (Society for Human Resource Management, 2102).

Capital budgeting is the most important management tool that enables managers of the organization to select the investment option that yields comprehensive cash flows and rate of return. For managers availability of capital whether in form of debt or equity is very limited and thus it become imperative for them to invest their limited and most important resource in perfect option that could prove to beneficial for the organization in the long run (Hickman et al, 2013). However, while using capital budgeting tool managers must understand its quantitative and qualitative considerations that are discussed below.