HPM_320_Presentation_FINAL

Brown&Co

Nash Health Care Strategic Plan

Group Project Work Sample 2

Brown&Co |

Executive Summary

2

External Environment

Stakeholder Analysis

Internal Environment

Strategy Recommendations

Conclusion

Directional Strategies & Strategic Position

Brown&Co |

Competitive Landscape

3

Strengths

Weaknesses

Hospital 1 Hospital 2 Hospital 3 UNC

• High NurseSatisfaction

• High Patient Satisfaction

• Relatively unclean and loud

• Image of being solely profit-driven

• First freestanding children’s EDin NC

• High volume Heart Centers

• Weak management team

• History of medical fraud

• Top 50 Ranking

• Patient Education Classes

• Limited parking

• Inconvenient location

• ExcellentAcademic Medical Center

• Strong Cancer care

• Long waiting times for appointments

• Poor readmission rates

Nash Health Care’s Service area includes Halifax, Edgecombe and Nash Counties.Major competitors are not local hospitals but those in neighboring cities.

Brown&Co |

Major trends affecting Nash Healthcare

4

National Trends

Affordable Care Act

“Doc Fix” Bill

Statewide Trends

Disposal of CONMedicaid

Management

King vs Burwell Case

Local Trends

Increasing at 3 % annually

Decreasing almost 6X faster

than State

Majority is Medicare and

Medicaid

2X state average

Aging Population

PayerMix

Lower MedianIncome

High Homicide Rates

Brown&Co |

Agenda

5





Conclusion


Brown&Co |


6

Nash Healthcare• Nash General Hospital • Nash Day Hospital• Bryant T. Aldridge

Rehabilitation Center• Coastal Plain Hospital• Emergency Care Center• Nash Healthcare Foundation• Nash Breast Care Center• Middlesex Powell Clinic

PayersMedicare Medicaid

Self-Pay Insurance

PatientsAdministrators Referral Networks

Partnerships• UNC Health Care• University Health

Systems of Eastern Carolina

• Vidant Health

Hospital Staff• Physicians• Nurses• Technicians• Other staff

State and Federal Government

Affiliated Organizations•UNC Healthcare•HealthFirst Wellness Center-•Bryant T. Aldridge Rehabilitation Center•Coastal Plain Hospital•Emergency Care Center•Nash Healthcare Foundation•Nash Breast Care Center•Middlesex Powell Clinic•Boice-Willis Clinic

Brown&Co |

Agenda

7





Conclusion


Brown&Co |

0.020.01

-0.04

-0.06

-0.04

-0.02

0

0.02

0.04

0.06

0.08

0.1

0.12

2011 2012 2013

Operating Margin

WakeMed Nash Rex UNC

Profitability

Increasing expenses&

Declining reimbursementsLead to

Declining profitability

Declining Reimbursements

Increasing expenses

2.43

1.45

1.89

4.01

2.07

Nash Rex UNC WakeMed Industry Avg

Current Ratios for 2013

0.5

0.57

0.48

0.74

Nash Rex UNC WakeMed

Financial Position

8

Liquidity

Days Cash on Hand : 216 days

Substantial Current Assets

Debt vs. Equity

Increasing expenses&

Declining reimbursementsLead to

Declining profitability

Debt Capacity

Nash has enough liquidity and debt capacity to focus on improving operating margins.

Brown&Co |

SWOT

9

Strengths

• Personnel• Location • Culture• Technology• Affiliation with UNC• New Emergency Department

Weaknesses

• Infrastructure• Limited no. specialties • Patient Satisfaction• Declining operating margins• High readmission rates

Opportunities

• High Obesity Rates• Partnership with UNC• Relationship with

Community College • Aging population

Threats

• Growing Uninsured population

• High Infant mortality rates• High homicide rates • Declining median household

income

Brown&Co |

Nash’s Strategic Position

10

Culture

Location

High Crime Rate

Competitive Disadvantages

Competitive Advantages

ThreatsOpportunities

No. Service Lines

Declining Reimbursements

High Obesity Rates

Low No. PCPs

Infrastructure

Enhance Services

Brown&Co |

Agenda

11





Conclusion


Brown&Co |

Directional Strategies

12

Ameliorate financial position

Enhance Public Perception

Enhance Patient Experience

Increase Employee

Satisfaction

Implement Quality Improvement Plan

Goals Strategies

Expand Bariatric Service Line

Introduce Primary Care Service Line

Our vision is to improve the health of the community by

delivering high quality care to our patients and by providing our

physicians and employees with outstanding facilities and

resources.

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Agenda

13





Conclusion


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Patient Satisfaction Quality Improvement

Brown&Co |

Nash lags behind other NC hospitals in terms of two key areas of patient satisfaction

15Source: U.S. News and World Report, Google Reviews

Room Cleanliness Billing Difficulties

71%

57%

State Average Nash Hospital

% of people who would recommend Nash

“E.R. is a long wait, inaccurate billing once. R.Ns are great. The assistants are slow and not helpful. Good parking availability”

“billing department could not trace the initial Copay paid to them and I end(ed) up paying copay twice…”

This 14% difference is due largely in part to a significant dissatisfaction with the standards

of cleanliness in patients’ rooms

Brown&Co |

Nash can improve quality by focusing on patient satisfaction

16

Checklists for• Post-Patient Discharge• Pre-Patient Discharge

Emphasize• Sanitation• Patient comes first

Implement Checklist System

Integrate My Nash Charts with billing capabilities

• Easily compare charges with services rendered

• Ensure one-stop destination for all of patient’s needs post-discharge

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Adding Primary Care Service Line

Brown&Co |

Establishing Primary Care Service Line

18

Growing Demand

Profitability Limited number

of PCPs

Increases in Bottom Line

Benefits

Strengthens Referral Network

Limitations

Improve Brand Equity

GreaterContinuum of

Care

Large Capital Investment

Large Time Investment

Brown&Co |

Methods for adding Primary Care Service Line

19

Pros Cons

Cooperation(Boice Willis)

• Control with little long term costs

• No need to invest in fixed assets

• Existing patient base

• Limited Control

Purchase(Family Medical Center of Rocky Mount)

• Immediate access to patient base

• No construction costs

• Integrating cultures• Transition challenges

Development (Build new facility)

• Complete control• Response to community

needs

• CON Regulation• Large upfront costs• Will take longer to build• Need to acquire market share

Brown&Co | 20

Expanding Bariatric Center

Brown&Co |

Nash’s Service Area is unhealthy

21Source: North Carolina County Health Rankings

2929 29 29 29

37

40 40

37

40

37

39 3938

39

3233 33 33

32

2011 2012 2013 2014 2015

% of Population that is Obese

North Carolina Edgecombe Halifax Nash

65% of Edgecombe County residents do not have access to “exercise opportunities”

10 10 1011 11

13 13 13

15 1515 15 15

1615

12 12 12 12 12

24 2524

26 26

2011 2012 2013 2014 2015

% of Population that is Diabetes

North Carolina Edgecombe Halifax Nash Service Area

Brown&Co |

Expanding Bariatric Surgery and Wellness Facilities

22

Expand Nash Surgical Weight Loss Center and HealthFirstWellness Center in Edgecombe County

ImprovesBottom Line

Growing Need

Reduction in Coverage Barriers

Brown&Co | 23

Implementation

Brown&Co |

Implementation Timeline and Considerations

24

2015 2016 2017 2018 2019 2020 2021

Challenges

• CON Regulations• Implementation Costs

Opportunities

• Improve community reputation

• Improve access to care

Complete implementation QI

Project

Complete Expansion of

Bariatric Center

Complete PCP Implementation

Brown&Co |

Conclusion

25





Conclusion


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Questions?

Brown&Co |

Appendix

• Financial Ratios

• TOWS matrix

• Organizational GOals

• Situational Assessment (Homicide Rates)

27

Brown&Co |

Directional Strategies

28

“To provide superior quality health care services and improve

the health of the community in a caring, efficient and financially

sound manner.”

Clear hope for the future

Challenging

Focused on Excellence

Inspirational

Empowers Employees

Provides Guidance

Our vision is to improve the health of the community by

delivering high quality care to our patients and by providing our

physicians and employees with outstanding facilities and

resources.

Brown&Co |

Organizational Goals

29

Ameliorate financial position

We will increase profitability by focusing on cutting costs and negotiating better reimbursement rates by leveraging our relationship with UNC.

Enhance Public Perception

We will invest in patient education, respond to negative reviews from patients and promote Nash’s unique service offerings.

Enhance Patient Experience

We will improve our facilities, implement stringent quality improvement standards and increase service offerings to respond to needs of community.

Increase Employee

Satisfaction

We will leverage our affiliation with UNC to create more educational opportunities as well as increase reimbursement rates, implement surveys to solicit employee input, and invest in new technologies.

Brown&Co |

Strategic Overview

30

Improve Current ServicesAdd

Service LineExpand Service Line

• Financial position• Public perception• Employee satisfaction

• Patient satisfaction• Public perception

• Financial position• Public perception• Patient satisfaction

Recommended strategies directly further the organizational goals and vision.

Documents

HPM_320_Presentation_FINAL