Comparing The Nadler And Tushman Congruence Model

Middlefield Hospital is an outstanding community hospital that has had an increase of more Medicare, Medicaid, and uninsured patients. With an influx of this payer mix receiving healthcare at our hospital has reduced the overall reimbursements and net income. I have met with the chief financial officer (CFO) and the hospital management team and discussed

In 1997 University of California, San Francisco (UCSF) merged its two public hospitals with Stanford’s two private hospitals. The two separate entities merged together to create a not-for-profit organization titled UCSF Stanford Health Care. The merger between the health systems at UCSF and Stanford seemed like a good idea due to the similar missions, proximity of institutions, increased financial pressure with cutbacks in Medicare reimbursements followed by a dramatic increase in managed care organizations. The first year UCSF Stanford Health Care produced a profit of $22 million, however three years later the health system had lost a total of $176 million (“UCSF-Stanford Merger,” n.d.). The first part of this paper will address reasons

Since most specialty procedures are inpatient services, EMC’s inpatient occupancy rate suffers. The occupancy rate for Emanuel Medical Center – fifty percent – is far below that of its competitors and industry benchmarks. To accompany this, EMC (on average) receives a lower reimbursement for in-patient Medicare services per patient seen in comparison to its competitors. A result such as this is correlated with directly to the fewer amount of specialty services that EMC offers. In order for Emanuel Medical Center to be able to compete with other hospitals in its service area, it is imperative that EMC evaluates what services they currently offer and are capable to offer in the future to add value to the hospital, increase its revenue stream, and expand its patient mix. Currently, Emanuel Medical Center has not succumbed to its increasing financial pressurealthough EMC has had a negative operating income for five straight years. A negative operating income places EMC at a disadvantage because it limits the hospitals ability to renovate its aging building or hire new specialists to offer revenue enhancing procedures. EMC’s competitors, on the other hand, have large sources of revenue due to their mergers with large healthcare networks such as Catholic Healthcare West. Another competitor, Kaiser Permanente Modesto Medical Center, has extremely large financial resources due to the fact

Typically, the concept of organizational change is in regard to organization change, as opposed to smaller changes such as adding a new person, modifying a program, etc. Examples of organization-wide change might include a change in

The Stanford Health Services and UCSF medical center merger was projected to have a great turnout as it was supposed to be “enhanc[ing] the academic mission[s], strengthen[ing] referrals, and creat[ing] a more cost effective teaching hospital” (Sjoberg, 1999). The two competitors joined forces in hopes that it would alleviate the pressures of the new managed care systems by merging resources and acquiring more bargaining power. Stanford Medicine and UCSF came together at a time when many other academic health centers were looking to improve their negotiating powers with healthcare plans and physician groups. The merger offered hope to UCSF and Stanford by strengthening training programs and offering innovation plans as well as financial support.

There are millions of healthcare organizations all throughout our country. Some of these organizations have a significantly greater financial background than others, but that depends on the size, location, and demand of the patient population. The organization that is going to be discussed is Yale New Haven, which is a large hospital in southeast Connecticut. Their most recent data dates back to the fiscal year of 2014 when the hospital saw a total of 1.2 million patients, bringing in revenue close to 3.5 billion dollars. In fact, Yale New Haven has made close to a billion dollars more in revenue compared to the year of 2012. Without the help of the 6,000 medical personnel and the 20,000 members of the staff, this large hospital would never be as successful as it is today (Yale New Haven Health, n.d.). As one can see, the hospital is growing each and every year supplying the overall demand of the patient population.

In an attempt to learn what a thriving HIM department looks like, I and three of my classmates visited the offices of Diane Premeau, who holds an MBA, PHIA, CHP, and CHC, the HIM Director for O’Connor Hospital. Diane has been with O’Connor for approximately 10 years and she was an excellent source of information, was very energetic and was generous with her time. O’Connor is a non-profit hospital that has been in operation for over a 100 years. O’Connor is part of the Daughters of Charity Health System (DCHS). Earlier this year O’Connor hospital, a part of Verity Health announced a comprehensive revenue cycle management (RCM) agreement with Conifer Health Solutions.

Dr. Karen Buhr, PhD is the newly appointed Chief Operating Officer of Bellevue Hospital; a large, a not-for-profit hospital located in New York City. After two weeks of working in the public sector, she misses the benefits of a seemingly endless cash flow available when working in a world renowned, private academic hospital. Bellevue Hospital has been in deficit for the past two years and patient satisfaction regarding care is at an all-time low. Her first task is to develop and implement cost saving measures for the clinical services provided. She has met with clinical and administrative leaders to identify potential savings and other opportunities for improvement. However, she has hit a road block. How

There is a new trend in the health care provider market and the hospital has not stand ahead or abreast of the new trend. Today, it is estimated that 6,400 urgent care centers have been established nationwide (Ferenc & Stempniak, 2015). The American Academy of Urgent Care Medicine reports a higher number, 9,300 urgent care clinics estimation (Ferenc & Stempniak, 2015). Those numbers will grow. It is predicted that the “$14.5 billion urgent care industry will increase by 5.8 percent annually through 2018 to about $18.8 billion” (Ferenc & Stempniak, 2015, p.7). With numbers like that, it benefits the hospital to readjust its delivery of health services to look heavily at the new trend practices. The leaders failed to conduct a market and financial analysis. This may cause the hospital to loose its viability as a competitor. As a result, the hospital cannot identify market trends to stay ahead of the trends and be prepared to meet challenges that come along with those trends. In addition, it has failed to conduct a financial analysis to assess if it is profitable to implement new strategies to meet the market

Healthcare outcomes have become increasingly important, as organizations strive to improve quality and efficiency of care, while controlling cost. North Mississippi Medical Center (NMMC) has become a model of instituting strategies that contribute to high efficiency. According to Carroll &Edwards, “Leaders at NMMC believe that by focusing on serving patients, empowering staff, and improving health care quality, lower cost and growth will naturally follow”.

Financial security remains one of the hospital’s major challenges. Branding is also an issue. Tufts-NEMC does not have a strong presence in the local community, and can improve its standing among other AMCs. Findings its place among its competitors and creating a legacy are key components of sustainability.

Week 3, the lecture on Managing Change describes organizational changes that occur when a company makes a shift from its current state to some preferred future state. Managing organizational change is the process of planning and implementing change in organizations in such a way as to decrease employee resistance and cost to the organization while concurrently expanding the effectiveness of the change effort. Today's business environment requires companies to undergo changes almost constantly if they are to remain competitive. Students of organizational change identify areas of change in order to analyze them. A manager trying to implement a change, no matter how small, should expect to encounter some resistance from within the organization.

After reviewing and researching the literature with respect to organizational changes, I have come to the conclusion that organizations have always changed. When everything in the world is changing, organization cannot remain islands. They must change to face new challenges. Bolman and Deal (2008) claim organizations have changed about as much as in past few decades as in the preceding century. Bolman and Deal (2008) claim means that the change organizations have experienced in the last decade are almost similar to those they experience in at the end of the twentieth century.

Burke (2014) stated that organizations change from day to day. The changes that take place in organizations can be intentional or unintentional. Generally, the changes that occur is accidental. It is important to have a broader and deeper knowledge of understanding organization change. Understanding what is currently happening as well as trends in which the organization is functioning can provide such awareness.

For the purpose of this paper organizational change is defined as a company or organization going through a transformation. Organization change occurs when business strategies or major sections of an organization are altered and or involves reorganization, restructuring and turnaround (Business Dictionary). Organizational change is about reviewing and transforming management structures and business processes. To stay ahead of our competition the Charter School System it is imperative that our organization look for ways to do things more efficiently and economically. There is no reason that we should fear change. We should embrace change as a means of setting the foundation for continuing success (Basu, C., 2014).