Change and Culture Case Study

Generate a list of the ways in which you believe your responsibilities and the tasks you perform are likely to change because of the merger and your resulting new role. Hint: It may be helpful to make lists of what you imagine to be the circumstances before and after your appointment. For example, two obvious points of comparison involve number of employees (which implies many necessary tasks) and travel inherent in the job. See how long a list you are able to generate.

In 2012, the ACA found an excessive amount of readmissions of patients that were hospitalized within 30 days for the same medical conditions. This factor viewed under the ACA as a quality issue and CMS implemented value-based incentive payments based on performance in a set of quality measures. The plan is to implement a pay for performance (P4P) in formulas used by Medicare to reimbursement providers. “The objective is to link reimbursement to quality and efficiency as an incentive to improve the quality of health care, as well as reduce system-wide costs” (Shi and Singh, 2015). In addition to the P4P, nonprofit hospitals also focus on continual improvement, data and cost containment throughout the organization (Adamopoulos,

Health Care in the United States is a vast industry that has many different types of people involved in the delivery of care. There are stakeholders that affect the daily operations of health care and they are not necessarily in a hospital setting. The Agency for Healthcare Research and Quality, AHRQ, defines a “stakeholder” as persons or groups who have a vested interest in the clinical decision and the evidence that supports that decision ("Effective health care," 2011, p. 1). These stakeholders are making decisions that impact costs, procedures, and the future of

On paper, the merger between these two institutions made sense – both institutions were close to one another and competing for diminishing resources. Together they could reduce administrative costs and join forces to negotiate with large insurance companies. The need to create a new culture and dissolve historically existent power struggles were two large tasks that needed to be addressed in order to ensure a successful merger. However, the way in which the merger was organized did not lead to a successful merger. UCSF Health Care did not spend adequate time creating a shared culture in which the two organizations would see one joint organization with shared power (resources).

These mandates also require that some establishments provide customers with a good outcome and experience while at their facilities. There are also incentives provided to doctors who correctly diagnose their patients for the very first time reducing the rates of readmission this also applied to those that provided outstanding follow up care for patients “The new law provides incentives for physicians to join together to form “Accountable Care Organizations.” These groups allow doctors to better coordinate patient care and improve the quality, help prevent disease and illness and reduce unnecessary hospital admissions. If Accountable Care Organizations provide high quality care and reduce costs to the health care system, they can keep some of the money that they have helped save. Effective January 1, 2012” ( HHS>GOV).

Besides, the financial incentives for hospitals and physicians that belong to ACOs, Jaffery & Golden 2013, asked and then answered the question “why would providers join this program? One reason is to prepare for the future”. Fee-for-service reimbursement, which has been how hospitals get paid for their services rely solely on the volume of patient seen without taking into consideration the quality of care provided. Payers today, such as government, commercial insurers, employers, and individual consumers are now requesting on value -based-payment, which consist of delivering the highest level of care at a lower cost. The volume based system even though the traditional way of how payments are made is not a viable long-term option (Jaffery and Golden, 2013, p.98).

The scale of this scale is regional as it takes place primarily Sonora/Arizona region of the U.S./Mexico border and affects one specific group of people (migrants).

The American Hospital Association’s McKesson Quest for Quality Prize compares hospitals that are following certain criteria, such as, partnerships with consumers and families (Johnson et al., 2008). The hospital that receives this recognition also procures a $75,000 award. The Joint Commission includes the Patient-Centered Designation Program award on their website under a hospital’s profile, which people may view to take control of their health (Johnson et al., 2008). Many other institutions offer hospital acknowledgments like these that can promote innovation within hospitals, which can be slow to change.

Change can be devastating and not always everyone agree with it. The biggest transformation in healthcare is the implementation of the Affordable Care Act. With the new health care system the government mandated U.S. citizens and legal residents to have health insurance that resulted in the rise of insured individuals. Due to the new policy more people have access to health care that means more primary physician needed to accommodate the rise of new patients. Shortages of physicians not only in the primary care area but also in specialty care area are projected between 46,000-90,000 by 2025 ("The Physician Shortage," n.d.). The pay-for-performance focuses on quality that will eventually decrease the costs (James, 2012, p. 1). This system will give a reward or a bonus to the health care providers whenever they meet or exceed quality standard that are being set (James, 2012, p. 1). In contrary the system can also penalized those providers that are unsuccessful in providing the indicated goals or cost savings (James, 2012, p. 1-2). There are 2,225 hospitals in 2013 that were fined under the Hospital Readmissions Reduction Program (HRRP) which is part of the ACA regulation (Anderson, 2014, p. 11). For the institutions to survive with the new system a lot of hospitals are merging that a year after the ACA implementation there

A merger is a partial or total combination of two separate business firms and forming of a new one. There are predominantly two kinds of mergers: partial and complete. Partial merger usually involves the combination of joint ventures and inter-corporate stock purchases. Complete mergers are results in blending of identities and the creation of a single succeeding firm. (Hicks, 2012, p 491). Mergers in the healthcare sector, particularly horizontal hospital mergers wherein two or more hospitals merge into a single corporation, are increasing both in frequency and importance. (Gaughan, 2002). This paper is an attempt to study the impact of the merger of two competing healthcare organization and will also attempt to propose appropriate

Healthcare changes occur rapidly, and it’s a costly venture to constantly pay staff to research trends, and assist with implementation procedures. Organizations such as OAHHS have been developed to help remove that pressure individually, and allow Oregon hospitals to utilize the information that is provided and advocated for at the state level. Hospitals that take advantage of such programs benefit from this growing organization, which continues to hire new staff, are able to tackle specific projects that are of importance to those digesting information to tailor it for specialties.

When companies combine/merge the whole objective is to gain new opportunities, gain market share, grow the business, to become more innovative and to improve product offerings, utilizing/sharing the existing resources and data. From the case

Core changes are less common than peripheral changes in the organization of hospitals. Using Lee & Alexander’s study 1 percent of the hospitals had core changes compared to 36.6 percent having peripheral changes. The percentages of change clearly identify peripheral changes as the more common organizational changes thus making it the more detrimental of the two. Another limitation should have been added stating that the rates of failure in core changes was not separate nor compared to those of peripheral changes.

Post-merger integration work is difficult, political, and often driven by teams that still have day jobs. Budgets are undefined, executive leadership is not clear beyond the C-level, no plans exist, and no one has done it before. Companies are willing to spend money on due diligence ahead of signing the papers, but do not always follow through to ensure that targets are met. In many cases, integration team members are plucked from the “operate and maintain” staff, and either cannot see or do not share the strategic vision of the “design and build” dealmakers. Companies that thrive from mergers do eight things (at least) correctly: Have a Plan, Communicate, and Measure Results, Dedicate the Team, Automate, Plan for Turnover, Focus on Business

Hospitals and health systems in the U.S. are experiencing a remarkable transformation in their business models directed from numerous influences that are projected to ultimately turn the industry around. Pressures include providers troubled with the quantity of services they are responsible for, to providers who concentrate on presenting high-cost services that give emphasis to sustaining healthy populations (Dunn & Becker, 2013).